Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 10/2006

01-10-2006

A Brief Overview of Acute Respiratory Distress Syndrome

Author: Robert M. Hardaway, MD

Published in: World Journal of Surgery | Issue 10/2006

Login to get access

Abstract

Background

The low pO 2 in traumatic and septic shock was first documented at Walter Reed Army Medical Center starting in 1960. It was postulated that this respiratory failure was due to the occlusion of the pulmonary microcirculation by the microclots of disseminated intravascular coagulation (DIC).

Materials and Methods

Animal studies showed that pulmonary failure and death could be caused by intravenous injection of a killed culture of either Escherichia coli or pneumococcal organisms or by severe muscle contusion. Severe clinical septic and traumatic shock cases were studied.

Results

Injection of either killed E. coli or killed pneumococci resulted in acute respiratory distress syndrome (ARDS) and death in pigs. Muscle contusion also resulted in ARDS and death in pigs. Both ARDS and death were prevented by administration of a plasminogen activator, and ARDS in human septic or traumatic shock were safely and effectively treated by administration of a plasminogen activator.

Conclusions

Acute respiratory distress syndrome can be caused by DIC, which blocks the microcirculation of any and all organs. These microclots can be safely lysed by a plasminogen activator, thus treating ARDS and saving lives.
Literature
1.
The Medical Department of the United States Army in the World War. Surgery 1927;2:185
2.
Hardaway RM. Disseminated intravascular coagulation syndrome. Arch Surg 1961;83:842–850PubMed
3.
Hardaway RM. Syndromes of Disseminated Intravascular Coagulation with Special Reference to Shock and Hemorrhage. Springfield, IL, Charles C Thomas Publisher, 1966
4.
Hardaway RM. Pulmonary microthrombi (presented at symposium on pulmonary embolic disease, Boston, MA, 22 May 1964). In Sasahara AA, ed, Pulmonary Embolic Disease, New York, Bruce-Shatton, 1965:65–72
5.
Hardaway RM, James PM, Anderson RW, et al. Intensive study and treatment of shock in man. JAMA 1967;199:779–790PubMedCrossRef
6.
Hardaway RM. Shock lung. Int Surg 1973;58:311–315
7.
Hardaway RM. Care of the Wounded in Viet Nam, Manhattan, KS, Sunflower University Press, 1988:139–221
8.
Collins JA, Gordon WC Jr, Hudson TL, et al. Inapparent hypoxemia in casualties with wounded limbs. Ann Surg 1968;167:511–520PubMed
9.
Bredenberg CE, James PM, Collins J, et al. Respiratory failure in shock. Ann Surg 1969;169:220
10.
Collins JA. The cause of progressive pulmonary insufficiency in surgical patients. J Surg Res 1969:9
11.
Martin AM, Simmons RL, Heisterkamp CA 3rd, et al. Respiratory insufficiency in combat casualties. I. Pathologic changes in the lungs of patients dying of wounds. Ann Surg 1969;170:30–38PubMed
12.
Simmons RL, Martin AM, Heisterkamp CA 3rd, et al. Respiratory insufficiency in combat casualties. II. Pulmonary edema following head injury. Ann Surg 1969;170:39–44PubMedCrossRef
13.
Simmons RL, Heisterkamp CA 3rd, Martin AM, et al. Respiratory insufficiency in combat casualties. III. Arterial hypoxemia after wounding. Ann Surg 1969;170:45–52PubMed
14.
Simmons RL, Heisterkamp CA 3rd, Collins JA, et al. Acute pulmonary edema in battle casualties. J Trauma 1969;9:760–775PubMed
15.
Chiu D, Lubin B, Shohet SB. Erythrocyte membrane lipid reorganization during the sickling process. Br J Hematol 1974;41:223–234
16.
Feola M, Simoni J, Cnizaro PC, et al. Toxicity of polymerized hemoglobin solutions. Surg Gynecol Obstet 1988;166:211–222PubMed
17.
Ashbaugh DG, Bigelow DB, Petty TL, et al. Acute respiratory distress in adults. Lancet 1967:319–323
18.
Ashbaugh DG, Petty TL, Bigelow DB, et al. Continuous positive pressure breathing in ARDS. J Thorac Cardiovasc Surg 1969:57
19.
20.
Zeni F, Freeman BF, Natanson C. Anti-inflammatory therapies to treat sepsis and septic shock, a reassessment. Crit Care Med 1997;25:1095–1100PubMedCrossRef
21.
Natanson C, Hoffman WD, Suffredini AF. Selected treatment strategies for septic shock based on proposed mechanisms of pathogenesis. Ann Intern Med 1994;120:771–783PubMed
22.
Fein AM, Calalang-Colucci MG. Acute lung injury and acute respiratory distress syndrome in sepsis and septic shock. Crit Care Clin 2000;16:289–317PubMedCrossRef
23.
Baue AE. MOF, MODS, SIRS: Why no magic bullets? Arch Surg 1997;132:703–707
24.
U.S. Department of Commerce Bureau of Census Statistical Abstract of the United States 1995
25.
Balk RA. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit Care Clin 2000;16:337–352PubMedCrossRef
26.
Bernard GR, Vincent VL, Laterre PF. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699–709PubMedCrossRef
27.
Hardaway RM, Williams CH, Vasquez Y. Disseminated intravascular coagulation in sepsis. Semin Thrombosis Hemost 2001;27:577–583CrossRef
28.
Hardaway RM, Vasquez Y. A shock toxin that produces disseminated intravascular coagulation and multiple organ failure. Am J Med Sci 2001;322:222–228PubMedCrossRef
29.
30.
Gando S, Nanzaki S, Morimoto Y, et al. Systemic activation of tissue-factor dependent coagulation pathway in evolving acute respiratory distress syndrome in patients with trauma and sepsis. J Trauma 1999;47:719–723PubMed
31.
Gando S, Kamene T, Nanzaki S, et al. Participation of tissue factor and thrombin in posttraumatic systemic inflammatory syndrome. Crit Care Med 1997;25:1820–1826PubMedCrossRef
32.
Gando S, Kamene T, Morimoto Y, et al. Tissue factor production not balanced by tissue factor pathway inhibitor in sepsis promotes poor prognosis. Crit Care Med 2001;8:1729–1734
33.
Gando S, Kamene T, Matsuda N, et al. Combined activation of coagulation and inflammation has an important role in multiple organ dysfunction and poor outcome after severe trauma. Thrombohemostasis 2002;88:943–949
34.
Gando S, Nanzaki S, Kemmotsu. Disseminated intravascular coagulation and sustained systemic inflammatory response syndrome predict organ dysfunction after trauma. Ann Surg 1999;229:121–127
35.
Gando S, Kamene T, Nanzaki S, et al. Disseminated intravascular coagulation is a frequent complication of systemic inflammatory response syndrome. Thrombohemostasis 1996;75:224–228
36.
Gando S, Nanzaki S, Aoi K, et al. Activation of the extrinsic coagulation pathway in patients with sepsis and septic shock. Crit Care Med 1998;26:2005–2009PubMedCrossRef
37.
Oberhofer D, Kueisee-Tepes N, et al. Coagulation tests in septic shock patients. Acta Med Croatia 2004;58:389–394
38.
Hardaway RM, Williams CH, Marvasti M, et al. Prevention of adult respiratory distress syndrome with plasminogen activator in pigs. Crit Care Med 1990;18:1413–1418PubMed
39.
Hardaway RM, Burns VW. Mechanism of action of fibrinolysin in the prevention of “irreversible” hemorrhagic shock. Ann Surg 1963;157:305–309PubMedCrossRef
40.
Hardaway RM. Traumatic and septic shock alias post-trauma critical illness. Br J Surg 1998;85:1473–1479PubMedCrossRef
41.
Hardaway RM, Harke H, Tyroch A. Treatment of acute respiratory distress syndrome: a final report on a Phase I study. Am Surg 2001;67:377–382PubMed
42.
Hardaway RM. Traumatic shock. Mil Med 2006:171
Metadata
Title
A Brief Overview of Acute Respiratory Distress Syndrome
Author
Robert M. Hardaway, MD
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 10/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-006-0030-8

Other articles of this Issue 10/2006

World Journal of Surgery 10/2006 Go to the issue

INVITED COMMENTARY

Intraductal Papillary Mucinous Neoplasia

INVITED COMMENTARY

Invited Commentary to Indirect Inguinal Hernia: Towards Less Invasive Surgery in Rural Conditions

OriginalPaper

Adrenal Cysts: An Institutional Experience

OriginalPaper

Management of Right Colon Diverticulitis: A 10-Year Experience

OriginalPaper

Assessment of Nutritional Status and Prediction of Postoperative Liver Function from Serum Apolioprotein A-1 Levels with Hepatectomy

OriginalPaper

Prophylactic Antibiotics in Chest Trauma: A Meta-analysis of High-quality Studies