Bench-to-bedside review: Distal airways in acute respiratory distress syndrome

Manu Jain*, J. Iasha Sznajder

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


Distal airways are less than 2 mm in diameter, comprising a relatively large cross-sectional area that allows for slower, laminar airflow. The airways include both membranous bronchioles and gas exchange ducts, and have been referred to in the past as the 'quiet zone', in part because these structures were felt to contribute little to lung mechanics and in part because they were difficult to study directly. More recent data suggest that distal airway dysfunction plays a significant role in acute respiratory distress syndrome. In addition, injurious mechanical ventilation strategies may contribute to distal airway dysfunction. The presence of elevated airway resistance, intrinsic positive end-expiratory pressure or a lower inflection point on a pressure-volume curve of the respiratory system may indicate the presence of impaired distal airway function. There are no proven specific treatments for distal airway dysfunction, and protective ventilation strategies to minimize distal airway injury may be the best therapeutic approach at this time.

Original languageEnglish (US)
Article number206
JournalCritical Care
Issue number1
StatePublished - Feb 15 2007

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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