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• W2097036700 abstract "The acute respiratory distress syndrome (ARDS) is an acute and severe form of microvascular lung injury which is frequently seen in intensive therapy units. Reductions in mortality have been reported by some centres; however, 40–70% of patients still die from this syndrome.1 2 Treatment at present is largely supportive and, despite our increased understanding of the pathological processes involved, there are no specific treatments of proven benefit.Interstitial and intra-alveolar fibrosis are hallmarks of the more advanced stages of ARDS and are characterised by the abnormal and excessive deposition of extracellular matrix proteins, in particular collagen.3 4 Histologically and biochemically this is similar to the fibrosis seen in other more chronic forms of interstitial lung disease4; however, more is known of the mediators and cellular events that occur in these disorders. The decrease in pulmonary compliance and progressive hypoxia resulting from fibrotic change leads to ventilator dependence. As a result, progressive fibrosis is a direct cause of respiratory death in up to 40% of patients3 5 but is also an indirect cause of death due to nosocomial infection and progressive multi-organ failure in up to 70% of patients who die from ARDS.6 Thus, the fibrotic process is an important determinant of outcome and a potential target for therapeutic intervention.ARDS is traditionally divided into three phases: exudative, proliferative and fibrotic (fig 1). The initial exudative phase involves the leakage of proteinaceous fluid and the migration of cells, in particular neutrophils, from the circulation into the interstitium and alveolar space following diffuse damage to the endothelial and epithelial surfaces. The proliferation of fibroblasts and type II pneumocytes characterises the second phase during which activated fibroblasts secrete a number of extracellular matrix proteins within the interstitium but also migrate into the alveolar space where they form …" @default.
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• W2097036700 date "1998-10-01" @default.
• W2097036700 modified "2023-10-14" @default.
• W2097036700 title "The acute respiratory distress syndrome: fibrosis in the fast lane" @default.
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• W2097036700 doi "https://doi.org/10.1136/thx.53.10.815" @default.
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