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Published on: March 21, 2021

Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

Alexandre de Matos Soeiro1, Edwin Roger Parra, Mauro Canzian

  • 1Faculdade de Medicina da Universidade de São Paulo - FMUSP, University of São Paulo School of Medicine, São Paulo, Brazil.

Jornal Brasileiro De Pneumologia : Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia
|March 18, 2008
PubMed
Abstract

Insights

Pulmonary autopsy findings in patients with acute respiratory failure (ARF) revealed four main histopathological patterns: diffuse alveolar damage (DAD), pulmonary edema, lymphocytic interstitial pneumonia (LIP), and alveolar hemorrhage. Underlying diseases and risk factors influenced these patterns.

Area of Science:

  • Pulmonary Pathology
  • Critical Care Medicine
  • Forensic Pathology

Background:

  • Acute respiratory failure (ARF) is a critical condition with significant mortality.
  • Understanding the pulmonary histopathological alterations in ARF is crucial for diagnosis and management.
  • Autopsy findings provide definitive insights into the terminal pulmonary pathology.

Purpose of the Study:

  • To document the spectrum of pulmonary histopathological alterations in patients who died from ARF.
  • To investigate the association between underlying diseases, risk factors, and specific histopathological patterns in ARF.

Main Methods:

  • Retrospective review of 3030 autopsy reports of patients aged >1 year with ARF.
  • Inclusion criteria: underlying disease, associated risk factors, diffuse infiltrates, and ARF-related pulmonary alterations.
  • Analysis of histopathological findings and correlation with clinical data.

Main Results:

  • The primary histopathological patterns identified were diffuse alveolar damage (DAD), pulmonary edema, lymphocytic interstitial pneumonia (LIP), and alveolar hemorrhage.
  • Common underlying diseases included AIDS, sepsis, bronchopneumonia, and cancer.
  • Key risk factors were age >50, hypertension, diabetes, and chronic obstructive pulmonary disease (COPD).
  • Specific correlations were observed: AIDS with LIP; sepsis/liver cirrhosis with DAD; thromboembolism with alveolar hemorrhage; AMI with pulmonary edema, all in conjunction with risk factors.

Conclusions:

  • Four main histopathological patterns (DAD, pulmonary edema, LIP, alveolar hemorrhage) characterize ARF deaths.
  • Underlying diseases and specific risk factors are significantly associated with distinct histopathological findings in ARF patients.

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