Acute respiratory distress syndrome: does histology matter?

José A Lorente,Raquel Herrero,Andrés Esteban,Aida Ballén-Barragán

doi:10.1186/s13054-015-1022-6

Abstract

Kao et al. have reported in Critical Care the histological findings of 101 patients with acute respiratory distress syndrome (ARDS) undergoing open lung biopsy. Diffuse alveolar damage (DAD), the histological hallmark of ARDS, was present in only 56.4 % of cases. The presence of DAD was associated with higher mortality. Evidence from this and other studies indicates that the clinical criteria for the diagnosis of ARDS identify DAD in only about half of the cases. On the contrary, there is evidence that the clinical course and outcome of ARDS differs in patients with DAD and in patients without DAD. The discovery of biomarkers for the physiological (increased alveolocapillary permeability) or histological (DAD) hallmarks of ARDS is thus of paramount importance.

Highlights

Kao et al have reported in Critical Care the histological findings of 101 patients with acute respiratory distress syndrome (ARDS) undergoing open lung biopsy
Kao et al [1] have made an important contribution to the knowledge of the histological changes associated with acute respiratory distress syndrome (ARDS) and the potential role of open lung biopsy (OLB) in the diagnosis and management of ARDS
The authors studied the histological findings in OLB from 101 patients with a diagnosis of ARDS over 15 years

Summary

Introduction

Kao et al have reported in Critical Care the histological findings of 101 patients with acute respiratory distress syndrome (ARDS) undergoing open lung biopsy. Kao et al [1] have made an important contribution to the knowledge of the histological changes associated with acute respiratory distress syndrome (ARDS) and the potential role of open lung biopsy (OLB) in the diagnosis and management of ARDS. The authors studied the histological findings in OLB from 101 patients with a diagnosis of ARDS over 15 years.

Results

Conclusion