Pulmonary microvascular fracture in a patient with acute respiratory distress syndrome.
OBJECTIVE
To present electron micrographs of lung tissue obtained from a patient exposed to high ventilatory pressures in the context of pulmonary dysfunction and pulmonary hypertension.


METHODS
Case report.


METHODS
Adult intensive care unit of a university-affiliated teaching hospital.


METHODS
A patient exposed to high-pressure mechanical ventilation during support for acute respiratory distress syndrome; the acute respiratory distress syndrome in this case was secondary to septic shock.


RESULTS
Scanning electron micrographs of lung tissue, focusing on the internal alveolar surfaces.


RESULTS
Multiple gross disruptions of the alveolar walls, suggestive of stress fractures.


CONCLUSIONS
High-pressure mechanical ventilation may promote fracturing of the alveolar blood:airspace barrier.
Hotchkiss
John R
JR
Department of Critical Care Medicine, Regions Hospital and University of Minnesota Medical School, St. Paul, MN, USA
Simonson
Dana A
DA
Marek
Daniel J
DJ
Marini
John J
JJ
Dries
David J
DJ
D000368:Aged; D002196:Capillaries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008855:Microscopy, Electron, Scanning; D011650:Pulmonary Alveoli / Q000098:blood supply* / Q000000981:diagnostic imaging; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000473:pathology* / Q000628:therapy; D014463:Ultrasonography