Pathophysiology of pulmonary hypertension in acute lung injury

Am J Physiol Lung Cell Mol Physiol. 2012 May 1;302(9):L803-15. doi: 10.1152/ajplung.00355.2011. Epub 2012 Jan 13.


Acute lung injury (ALI) and acute respiratory distress syndrome are characterized by protein rich alveolar edema, reduced lung compliance, and acute severe hypoxemia. A degree of pulmonary hypertension (PH) is also characteristic, higher levels of which are associated with increased morbidity and mortality. The increase in right ventricular (RV) afterload causes RV dysfunction and failure in some patients, with associated adverse effects on oxygen delivery. Although the introduction of lung protective ventilation strategies has probably reduced the severity of PH in ALI, a recent invasive hemodynamic analysis suggests that even in the modern era, its presence remains clinically important. We therefore sought to summarize current knowledge of the pathophysiology of PH in ALI.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Lung Injury / blood
  • Acute Lung Injury / complications
  • Acute Lung Injury / pathology
  • Acute Lung Injury / physiopathology*
  • Animals
  • Blood Cells / pathology
  • Blood Cells / physiology
  • Blood Physiological Phenomena
  • Endothelium / physiopathology
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / pathology
  • Hypertension, Pulmonary / physiopathology*
  • Lung / blood supply
  • Lung / pathology
  • Lung / physiopathology
  • Microvessels / pathology
  • Microvessels / physiopathology