1. Pathogenesis of acute respiratory distress syndrome (ARDS); the left column represents the alveolar complex coupled with the interstitial space and capillary; the right column represents the lung.
Pathogenesis of acute respiratory distress syndrome (ARDS); the left column represents the alveolar complex coupled with the interstitial space and capillary; the right column represents the lung. N: normal homogenous alveoli; 1: occult ARDS with interstitial oedema, but no alveolar oedema or significant clinical symptoms; 2: pseudo-ARDS with interstitial oedema and initiation of alveolar oedema with surfactant deactivation, alveolar instability and clinical hypoxaemia; 3: fulminant-ARDS with interstitial and alveolar oedema, surfactant deactivation and refractory hypoxaemia. The triad of alveolar oedema, instability and surfactant deactivation can propagate from one stage to the next with ventilator-induced lung injury, but can be reversed with appropriately applied mechanical ventilation settings. Reproduced and modified from [9] with permission.
Michaela Kollisch-Singule et al. Eur Respir Rev 2019;28:180126
©2019 by European Respiratory Society