Abstract
Background: Acute respiratory distress syndrome (ARDS) is a severe and often fatal disease. The causes that lead to ARDS are multiple and include inhalation of salt water, smoke particles, or as a result of damage caused by respiratory viruses. ARDS can also arise due to systemic complications such as blood transfusions, sepsis, or pancreatitis. Unfortunately, despite a high mortality rate of 40%, there are limited treatment options available for ARDS outside of last resort options such as mechanical ventilation and extracorporeal support strategies.Aim of review: A complication of ARDS is the development of pulmonary hypertension (PH); however, the mechanisms that lead to PH in ARDS are not fully understood. In this review, we summarize the known mechanisms that promote PH in ARDS.Key scientific concepts of review: (1) Provide an overview of acute respiratory distress syndrome; (2) delineate the mechanisms that contribute to the development of PH in ARDS; (3) address the implications of PH in the setting of coronavirus disease 2019 (COVID-19).
Highlights
Acute respiratory distress syndrome (ARDS) is a severe form of lung respiratory failure characterized by diffuse alveolar damage, inflammation, and acute onset of hypoxemia not explained by cardiac failure
It is primarily through AT1R that angiotensin II (AngII) causes growth and proliferation of pulmonary artery smooth muscle cells (PASMCs) correlated with pulmonary vascular remodeling (Morrell et al, 1999). This is attributed to AngII-mediated increases in expression of pro-inflammatory genes including interleukin-10 (IL-10), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and intracellular adhesion molecule-1 (ICAM-1) in fibroblasts and smooth muscle cells (Xianwei et al, 2012)
Evidence that pulmonary hypertension (PH) increases the mortality in patients with ARDS is suggested by some studies, but definitive evidence is thwarted by inconsistent reports (Beiderlinden et al, 2006; ÑamendysSilva et al, 2014; Calcaianu et al, 2017)
Summary
Acute respiratory distress syndrome (ARDS) is a severe and often fatal disease. The causes that lead to ARDS are multiple and include inhalation of salt water, smoke particles, or as a result of damage caused by respiratory viruses. ARDS can arise due to systemic complications such as blood transfusions, sepsis, or pancreatitis. Aim of review: A complication of ARDS is the development of pulmonary hypertension (PH); the mechanisms that lead to PH in ARDS are not fully understood. We summarize the known mechanisms that promote PH in ARDS. Key scientific concepts of review: (1) Provide an overview of acute respiratory distress syndrome; (2) delineate the mechanisms that contribute to the development of PH in ARDS; (3) address the implications of PH in the setting of coronavirus disease 2019 (COVID-19).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
