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Diffuse alveolar damage (DAD) is a histologic term used to describe specific changes that occur to the structure of the lungs during injury or disease.Most often DAD is described in association with the early stages of acute respiratory distress syndrome (). [1]
Pulmonary edema (British English: oedema), also known as pulmonary congestion, is excessive fluid accumulation in the tissue or air spaces (usually alveoli) of the lungs. [1] This leads to impaired gas exchange , most often leading to shortness of breath ( dyspnea ) which can progress to hypoxemia and respiratory failure .
In uncommon instances, if ARDS appears acutely, in the absence of known triggers, and follows a rapidly progressing clinical course, the term "Acute interstitial pneumonia" is used. [1] ARDS is distinguished from the chronic forms of interstitial pneumonia such as idiopathic pulmonary fibrosis .
The pathophysiology of acute respiratory distress syndrome involves fluid accumulation in the lungs not explained by heart failure (noncardiogenic pulmonary edema). It is typically provoked by an acute injury to the lungs that results in flooding of the lungs' microscopic air sacs responsible for the exchange of gases such as oxygen and carbon dioxide with capillaries in the lungs. [1]
Alveolar lung disease may be divided into acute or chronic. Causes of acute alveolar lung disease include pulmonary edema (cardiogenic or neurogenic), pneumonia (bacterial or viral), systemic lupus erythematosus, [2] bleeding in the lungs (e.g., Goodpasture syndrome), [3] idiopathic pulmonary hemosiderosis, [4] and granulomatosis with polyangiitis.
Bat wing appearance is a radiologic sign referring to bilateral perihilar lung shadowing seen in frontal chest X-ray and in chest CT. [1] [2] The most common reason for bat wing appearance is the accumulation of oedema fluid in the lungs. [3]
It is often impossible to distinguish TRALI from acute respiratory distress syndrome (ARDS). The typical presentation of TRALI is the sudden development of shortness of breath, severe hypoxemia (O 2 saturation <90% in room air), low blood pressure, and fever that develop within 6 hours after transfusion and usually resolve with supportive care within 48 to 96 hours.
The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation. [3]
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