Pulmonary microvascular fracture in a patient with acute respiratory distress syndrome

Crit Care Med. 2002 Oct;30(10):2368-70. doi: 10.1097/00003246-200210000-00030.


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.

Design: Case report.

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

Patients: 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.

Measurements and main results: Scanning electron micrographs of lung tissue, focusing on the internal alveolar surfaces.

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

Conclusion: High-pressure mechanical ventilation may promote fracturing of the alveolar blood:airspace barrier.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Capillaries / diagnostic imaging
  • Female
  • Humans
  • Microscopy, Electron, Scanning
  • Pulmonary Alveoli / blood supply*
  • Pulmonary Alveoli / diagnostic imaging
  • Respiration, Artificial / adverse effects*
  • Respiratory Distress Syndrome / pathology*
  • Respiratory Distress Syndrome / therapy
  • Ultrasonography