The acute respiratory distress syndrome (ARDS) is traditionally thought to occur in three temporally discrete, histologically distinct phases: the acute exudative phase (days 1 to 7), the fibroproliferative phase (days 7 to 21), and the fibrotic phase (> 21 days). However, evidence from lung biopsy and bronchoalveolar lavage studies in ARDS patients suggests that the fibroproliferative phase occurs much earlier than commonly thought and is often concurrent with the exudative phase. Procollagen III peptide (a marker for new collagen synthesis) can be found in the pulmonary edema fluid of ARDS patients at time of intubation. In addition, histologic fibrosis and elevated bronchoalveolar lavage procollagen III peptide levels predict higher mortality rates. Lastly, preliminary evidence suggests that treatment aimed at fibroproliferation is associated with improved outcome.
- Acute lung injury
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine