Pulmonary microvascular fracture in a patient with acute respiratory distress syndrome

John R. Hotchkiss, Dana A. Simonson, Daniel J. Marek, John J. Marini, David J. Dries

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective: To present electron micrographs of lung tissue obtained from a patient exposed to high ventilatory pressures in the context of pulmonary dysfunction and pulmonary hypertension. Design: Case report. Setting: Adult intensive care unit of a university-affiliated teaching hospital. Patients: A patient exposed to high-pressure mechanical ventilation during support for acute respiratory distress syndrome; the acute respiratory distress syndrome in this case was secondary to septic shock. Measurements and Main Results: Scanning electron micrographs of lung tissue, focusing on the internal alveolar surfaces. Findings: Multiple gross disruptions of the alveolar walls, suggestive of stress fractures. Conclusion: High-pressure mechanical ventilation may promote fracturing of the alveolar blood:airspace barrier.

Original languageEnglish (US)
Pages (from-to)2368-2370
Number of pages3
JournalCritical care medicine
Issue number10
StatePublished - Oct 1 2002


  • Acute lung injury
  • Acute respiratory distress syndrome
  • Mechanical ventilation
  • Pulmonary microvascular stress fractures
  • Respiratory failure
  • Ventilation strategies


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