What is the pathophysiology of acute respiratory distress syndrome (ARDS) and what are the phases of ARDS in sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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The central pathologic finding in ARDS is severe injury to the alveolocapillary unit. After initial extravasation of intravascular fluid, inflammation and fibrosis of pulmonary parenchyma develop into a morphologic picture termed diffuse alveolar damage (DAD). The clinical and pathologic evolution can be categorized into the following 3 overlapping phases [27] :

  • Exudative phase (edema and hemorrhage)

  • Proliferative phase (organization and repair)

  • Fibrotic phase (end-stage fibrosis)

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