Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 48 , ISSUE 1 ( January-March, 2014 ) > List of Articles

RESEARCH ARTICLE

Acute Respiratory Distress Syndrome: An Autopsy Study

Suchet Sachdev, Shobhana Pravin Pandit

Citation Information : Sachdev S, Pandit SP. Acute Respiratory Distress Syndrome: An Autopsy Study. J Postgrad Med Edu Res 2014; 48 (1):8-13.

DOI: 10.5005/jp-journals-10028-1092

Published Online: 00-03-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To find out prevalence and the associated predisposing etiologic conditions of acute respiratory distress syndrome (ARDS) amongst autopsied cases.

Setting and design

The present study was a retrospective analysis of 125 cases of ARDS obtained at autopsy over a span of 4 years from 2000-2003.

Materials and methods

Data was retrieved from the postmortem record of the pathology department and the medical record department. A review of histology slides was done with diffuse alveolar damage (DAD) as the correlate of ARDS at histopathology.

Results

Prevalence of ARDS amongst autopsied cases was 3.15%. There were 60% cases in adult age group and of male gender; whereas 40% were children and of female gender. Almost 90% of cases succumbed to ARDS within a week of admission. The most common presenting features were of the respiratory system. The most common predisposing etiologic association was leptospirosis, septicemia and pneumonia.

Conclusion

Systemic infections were the most common predisposing etiologic conditions of ARDS at autopsy.

How to cite this article

Sachdev S, Pandit SP. Acute Respiratory Distress Syndrome: An Autopsy Study. J Postgrad Med Edu Res 2014;48(1):8-13.


PDF Share
  1. Acute respiratory distress syndrome. Harrison's principles of internal medicine. Longo DL, Kasper DL, Jameson JJ, Fauci AS, Hauser SS, Loscalzo J, editors. 18th ed. McGraw-Hill 2012;2205-2209.
  2. The American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818-824.
  3. Adult respiratory distress syndrome. Spencer's pathology of the lung. Hasleton PS, editors. 5th ed. McGraw-Hill 1996;375-400.
  4. Pulmonary edema and adult respiratory distress syndrome. Crofton and douglas's respiratory diseases. Seaton A, Seaton S, Leitch AG, editors. 5th ed. Blackwell Science 2000;770-787.
  5. Pulmonary pathology of acute respiratory distress syndrome. Clin Chest Med 2000;21:435-66.
  6. Accuracy of clinical diagnosis of acute respiratory distress syndrome in comparison with autopsy findings. J Bras Pneumol 2007;33:423-428.
  7. ARDS. Am Rev Resp Dis 1985;132:472-478.
  8. Risk factors for ARDS in the United States: analysis of the 1993 National Mortality Follow back Study. Chest 2001;119:1179-1184.
  9. Demographic, etiological and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies. Clinics (Sao Paulo) 2011;66: 1193-1197.
  10. A multicenter registry of patients with acute respiratory distress syndrome. Am Rev Resp Dis 1992;146:419-426.
  11. Incidence, site, and outcome of infections in patients with the ARDS. Am Rev Respir Dis 1986;134:12-16.
  12. Clinical characteristics and outcomes of patients with acute lung injury and ARDS. J Postgrad Med 2011;57:286-290.
  13. Acute respiratory distress syndrome in a pediatric intensive care unit. Med J Malaysia 1999;54:225-229(Abstract).
  14. Postmortem histological pulmonary analysis in patients with HIV/AIDS. Clinics (Sao Paulo) 2008;63:497-502.
  15. Acute respiratory distress complicating Plasmodium vivax malaria. Crit Care Med 2001;29:665-667.
  16. ARDS complicating plasmodium falciparum malaria. Heart and Lung 2000;29:294-297.
  17. Histopathology of fatal respiratory distress caused by plasmodium vivax malaria. Am J Trop Med Hyg 2009;81:758-762.
  18. Respiratory manifestations of malaria. Chest 2012;142:492-505.
  19. Acute respiratory failure complicating advanced liver disease. Semin Respir Crit Care Med 2012;33:96-110.
  20. Extracorporeal membrane oxygenation in severe acute respiratory failure in postpartum woman with rheumatic mitral valve disease: benefit, factors furthering the success of this procedure and review of the literature. J Extra Corpor Technol 2007;39:112-116.
  21. ARDS in systemic lupus erythematosus: causes and prognostic factors: a single center, retrospective study. Lupus 1999;8: 552-557.
  22. Terminal diffuse alveolar damage in relation to interstitial pneumonias. An autopsy study. Am J Clin Pathol 2003;119:709-714.
  23. Emergencies in rheumatology. J Indian Med Assoc 2003;101:520-524.
  24. The lung in polyarteritis nodosa: a pathologic study of 10 cases. Hum Pathol 1993;24:717-724.
  25. Hemoptysis and the ARDS as the causes of death in Leptospirosis. Changes in the clinical and anatomicopathological patterns. Rev Med Trop 1994;25:261-270.
  26. Pulmonary complications of leptospirosis. Clin Chest Med 2002;23:469-478.
  27. Epidemic of leptospirosis: an ICU experience. J Assoc Physicians India 2004;52:619-622.
  28. Pathology and pathophysiology of pulmonary manifestations in leptospirosis. Braz J Infect Dis 2007;11:142-148.
  29. Clinical aspects and prognostic factors of leptospirosis in adults. Retrospective study in France. J Infect 2008;57:171-178.
  30. Leptospirosis presenting as acute respiratory distress syndrome (ARDS) in sub-Himalayan region. J Assoc Physicians India 2010;58:390-391.
  31. Pulmonary manifestations of leptospirosis. Rev Mal Respir 2011;28:131-139.
  32. Discrepancy between clinical criteria for diagnosing acute respiratory distress syndrome secondary to community acquired pneumonia with autopsy findings of diffuse alveolar damage. Respir Med 2011;105:1170-1175.
  33. ARDS after open heart surgery. Orvsi Hetilap 2000;141:493-496(Abstract).
  34. Effects of chronic hepatic dysfunction on pulmonary glutathione homeostasis. Alcohol Clin Exp Res 2002;26:1840-1845(Abstract).
  35. Miliary tuberculosis presenting as acute respiratory distress syndrome, septic shock, DIC and multiorgan failure. Tenn Med 2004;97:164-166(Abstract).
  36. Evaluation of lepto dri dot as a rapid test for the diagnosis of leptospirosis. Epidemiol Infect 2002;129:617-621.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.