A study on risk factors of acute respiratory distress syndrome in comparison with autopsy findings

The present study was undertaken in order to describe histopathological changes by studying risk factors which will lead to development of ARDS. We investigated a total of 50 cases (31 males) ranging in age from 18–63 years. The extent of diffuse alveolar damage, a classical histopathological manifestation of ARDS was assessed. Burns was the most commonly presented risk factor constituting 34% of the total cases. Overall extra pulmonary cases were 78% and pulmonary cases constituted 22% of total number of cases. Gross examination showed 7 cases of consolidation and 4 cases of superficial hemorrhage. On histopathology, 8 cases showed hyaline membranes, Interstitial and Intra-alveolar edema and inflammation and Intra alveolar hemorrhage. In 4 cases, findings of type 2 pneumocyte proliferations were present. 42 cases showed no significant findings. Overall, 1 case of septicemia, 2 cases of major trauma with shock,4 cases of burns, 1 case of aspiration of gastric contents were found positive for ARDS. 8 cases (16%) fulfilled histopathological criteria for diagnosis of ARDS in our study. Study described etiologic and histopathological basis of ARDS, and summarizes our understanding of how the co-relation exists between postmortem histopathological findings with known risk factors of ARDS. We conclude that autopsy in cases with risk factors for ARDS will help in diagnosis & better understanding of the condition.