急性呼吸窘迫综合征
医学
病因学
重症监护医学
肺炎
呼吸窘迫
组织病理学
弥漫性肺泡损伤
败血症
低氧血症
急性呼吸窘迫
病理
内科学
肺
外科
作者
Leonardo José Tadeu de Araújo,Ligia Cândido de Oliveira Louzado,Cinthya dos Santos Cirqueira,Rodrigo Albergaria Réssio,Marcelo Sansone,Juliana Mariotti Guerra
出处
期刊:Applied Immunohistochemistry & Molecular Morphology
日期:2023-04-03
卷期号:31 (5): 311-317
标识
DOI:10.1097/pai.0000000000001121
摘要
Acute respiratory distress syndrome (ARDS) is a life-threatening condition due to acute lung injury (ALI), characterized by rapid-onset respiratory failure, leading to the clinical manifestations of poor lung compliance, severe hypoxemia, and dyspnea. ARDS/ALI has many causes, most commonly related to infections (sepsis, pneumonia), traumas, and multiple transfusions. The objective of this study is to assess the performance of postmortem anatomopathological examination in identifying etiological agents associated with ARDS or ALI in deceased patients from the State of São Paulo from 2017 to 2018. A retrospective cross-sectional study was performed based on the final outcome obtained by histopathology, histochemical, and immunohistochemical examination for ARDS/ALI differential diagnosis at the Pathology Center of the Adolfo Lutz Institute in São Paulo, Brazil. Of the 154 patients clinically diagnosed with ARDS or ALI, 57% tested positive for infectious agents, and the most frequent outcome was influenza A/H1N1 virus infection. In 43% of cases, no etiologic agent was identified. The opportunity to establish a diagnosis, identify particular infections, confirm a microbiological diagnosis, and uncover unanticipated etiologies is provided by postmortem pathologic analysis of ARDS. A molecular assessment could improve the diagnosis accuracy and lead to research into host responses and public health measures.
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