Pathophysiology of pulmonary hypertension in acute lung injury

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 mo...

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Bibliographic Details
Published in:American journal of physiology. Lung cellular and molecular physiology 2012-05, Vol.302 (9), p.L803-L815
Main Authors: Price, Laura C, McAuley, Danny F, Marino, Philip S, Finney, Simon J, Griffiths, Mark J, Wort, Stephen John
Format: Article
Language:English
Subjects:
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
Lungs
Microvessels - pathology
Microvessels - physiopathology
Morbidity
Mortality
Proteins
Respiratory distress syndrome
Review
Ventilation
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Summary: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.
ISSN:1040-0605
1522-1504
DOI:10.1152/ajplung.00355.2011