ArticleCritical care (London, England)2017
Predictors of diffuse alveolar damage in patients with acute respiratory distress syndrome: a retrospective analysis of clinical autopsies.
Article in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- Confocal laser endomicroscopy in patients with acute respiratory failure.Intensive care medicine experimental · 2026Article
- Is postoperative ARDS different from medical ARDS?Critical care (London, England) · 2026Article
- Refining an acute respiratory distress syndrome animal model supported by extracorporeal membrane oxygenator: incorporating clinically relevant mechanical ventilation strategy upon development.Intensive care medicine experimental · 2026Article
- Current Insights into Clinical, Molecular, and Therapeutic Approaches to Acute Respiratory Distress Syndrome.Medical sciences (Basel, Switzerland) · 2026Review
- The prognostic value of thromboelastography MA/R ratio in predicting mortality in acute respiratory failure patients.PloS one · 2026Article
- Article
- Overexpression of Wnt5a promoted the protective effect of mesenchymal stem cells on Lipopolysaccharide-induced endothelial cell injury via activating PI3K/AKT signaling pathway.BMC infectious diseases · 2024Article
- Challenges in ARDS Definition, Management, and Identification of Effective Personalized Therapies.Journal of clinical medicine · 2023Review
- Elevated plasma levels of Krebs von den Lungen-6 and geographic appearance on high-resolution computed tomography are associated with diffuse alveolar damage in autopsy cases of acute respiratory distress syndrome: a retrospective study.BMC pulmonary medicine · 2022Article
- Effects of High-Resolution CT Changes on Prognosis Predictability in Acute Respiratory Distress Syndrome with Diffuse Alveolar Damage.Journal of clinical medicine · 2022Article
- [Focus ventilation, oxygen therapy and weaning : Intensive medical care studies from 2020/2021].Der Anaesthesist · 2021Article
- Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia.Scientific reports · 2021Article
- Personalized mechanical ventilation in acute respiratory distress syndrome.Critical care (London, England) · 2021Review
- Frequency and Significance of Pathologic Pulmonary Findings in Postmortem Examinations-A Single Center Experience before COVID-19.Diagnostics (Basel, Switzerland) · 2021Article
- The Clinical Characteristics of ARDS in Children With Hematological Neoplasms.Frontiers in pediatrics · 2021Article
- [Is it really an acute respiratory distress syndrome? : Current definitions, pathophysiology and differentiated diagnoses].Der Anaesthesist · 2020Review
- Panitumumab-induced pulmonary toxicity.Current oncology (Toronto, Ont.) · 2019Article
- Predicting the Impact of Diffuse Alveolar Damage through Open Lung Biopsy in Acute Respiratory Distress Syndrome-The PREDATOR Study.Journal of clinical medicine · 2019Article
- Tuberculosis-induced acute respiratory distress syndrome treated with veno-venous extracorporeal membrane oxygenation.Respiratory medicine case reports · 2019Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough diffuse alveolar damage (DAD) is considered the typical histological pattern of acute respiratory distress syndrome (ARDS), only half of patients exhibit this morphological hallmark. Patients with DAD may have higher mortality than those without DAD. Therefore, we aimed to identify the factors associated with DAD in patients with ARDS.
methodsWe analyzed autopsy samples of 356 patients who had ARDS at the time of death. DAD was assessed by two pathologists, and ARDS criteria were evaluated by two intensivists. Criteria for severe ARDS included the degree of hypoxemia and the ancillary variables of the current Berlin definition assessed within 48 h before death: radiographic severity, high positive end-expiratory pressure (PEEP) level, and physiological variables (i.e., altered respiratory system compliance and large anatomic dead space).
resultsAfter multivariable analysis, high PEEP levels, physiological variables, and opacities involving only three quadrants on chest radiographs were not associated with DAD. The four markers independently associated with DAD were (1) duration of evolution (OR 3.29 [1.95-5.55] for patients with ARDS ≥ 3 days, p < 0.001), (2) degree of hypoxemia (OR 3.92 [1.48-10.3] for moderate ARDS and 6.18 [2.34-16.3] for severe ARDS, p < 0.01 for both), (3) increased dynamic driving pressure (OR 1.06 [1.04-1.09], p = 0.007), and (4) radiographic severity (OR 2.91 [1.47-5.75] for patients with diffuse opacities involving the four quadrants, p = 0.002). DAD was found in two-thirds of patients with a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen ≤ 100 mmHg and opacities involving the four quadrants.
conclusionsIn addition to severe hypoxemia, diffuse opacities involving the four quadrants were a strong marker of DAD.
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