Alteraciones patológicas de las vías respiratorias relacionadas con el síndrome de distrés respiratorio agudo y el daño alveolar difuso. Revisión narrativa
2019
Acute respiratory distress syndrome (ARDS)is a frequent and life-threatening entity. Recently, it has been
demonstrated that diffuse alveolar damage (DAD), which is considered the histological hallmark in spite
of presenting itself in only half of living patients with ARDS, exerts a relevant effect in the ARDS outcome.
Despite the fact that the bronchial tree constitutes approximately 1% of the lung volume, discovering a
relation between DAD and bronchial tree findings could be of paramount importance for a few reasons;
(a) it could improve the description of ARDS with DAD as a clinical–pathological entity, (b) it could
subrogate DAD findings with the advantage of their more accessible and safer analysis and (c) it could
allow the discovery of new therapeutic targets. This narrative review is focused on pathological airway
changes associated to Diffuse Alveolar Damage in the context of Acute Respiratory Distress Syndrome.
It is organized into five sections: main anatomical and functional features of the human airway, why
it is necessary to study airway features associated to DAD in patients with ARDS, pathological airway
changes associated with DAD in animal models of ARDS, pathological airway changes associated with
DAD in patients with ARDS, and the newest techniques for studying the histology of the bronchial tree
and lung parenchyma
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