ARDS - Acute Respiratory Distress Syndrome - Histopathology

[@abdulhaq5997]

Great video! Hard to find these types of pathology lectures, especially those for the pulmonary system and especiallyyy for medical school/USMLE prep. Thanks.

[@FilipSokol]

Thank you for your comment. I am glad you find it helpful.

[@maryammmm4739]

thank you!

[@braddavide311]

Good video, hyaline is still eluding my understanding. Can’t find any good info on HOW it’s formed. Is it a morphing of surfactant into a more fibrous material? Is it reversible? Also, is it’s formation what leads to ARDS related fibrosis? Anybody stumbles across a good video please share :)

[@FilipSokol]

Richard L. Kradin M.D., D.T.M. & H., in Understanding Pulmonary Pathology, 2017: The pathologic changes may be divided into two phases. The exudative phase occurs within the first 72 h of the insult. It is characterized by a profound increase in capillary permeability (Fig. 6.23A). There is alveolar filling by proteinaceous edema as well as multifocal alveolar hemorrhage and neutrophil infiltration. The sine qua non of acute alveolar wall damage is the hyaline membrane (Fig. 6.23B). It is composed of necrotic alveolar lining cells and fibrin that remain tightly apposed to the injured alveolar surfaces.

[@FilipSokol]

My understanding is that you have injury --> inflammation --> increased vascular permeability --> exudate --> fibrin rich fluid in the alveoli. fibrin + necrotic alveolar cells = hyaline membrane Surfactant depletion is responsible for colaps of the alveoli (or atelectasis in newborn RDS) but it is IMHO not part of the hyaline membrane. Mild cases of ALI/DAD/ARDS are reversible and some patients recover completely. More severe cases lead to fibrosis. Fibrosis is a healing process and the last part of the inflammatory response. It is caused primarily by injury and prolonged inflammation. Basically the whole process is very similar to injury, inflammation and healing elsewhere in the body. Unfortunately it is not very useful in the lungs and it does more harm than good.

[@braddavide311]

Filip Sokol, Thanks man that helps a lot actually. I never really considered alveolar tissue dealing with the standard inflammation process. That’s a nasty domino effect, no wonder so many ARDS survivors end up with some level of fibrosis.

[@Radar101music]

@@FilipSokol what an amazing explanation buddy. Bless you

[@xavierellis2692]

Thanks for the explanation! I am wondering what magnification this H&E stain is?

[@FilipSokol]

Hi Xavier. It is a virtual slide so the magnification is variable (up to 40x as the slide was scanned with 40x objective).

[@dralemsegedlecturessimplif4870]

Excellent Notes U encourage me to 've my channel in 2020.

[@FilipSokol]

Great to hear that. Good luck with your channel.

[@user-qn6cn8xc7d]

🌹🌹🌹🌹🌹

[@puneetpareek2897]

Good vedio

[@FilipSokol]

Thanks