Abstract

The high hospital mortality of Adult Respiratory Distress Sydrome (ARDS) has not diminished over the last years despite improvements in supportive intensive care. Diffuse alveolar damage (DAD) is the histopathologic finding that corresponds to the clinical entity of ARDS. The aim of this study is the histopathologic evaluation of the lungs in cases which were treated in intensive care units (ICU) and autopsied in the Council of Forensic Medicine. In reviewing the autopsy reports from the period 1999-2004 (18.508 cases), 77 cases hospitalized in ICU were selected. Classification was based on criteria like age, gender, duration of intensive care treatment, histopathologic assessment of lungs as well as the cause of death. Twelve of the cases were female and 65 male (F/M:1/3.6) with a mean age of 34.9 years ranging from 2 to 79 years. Hospitalization was necessary because of trauma in 66 cases, intoxication in 3 and natural reasons in 8 cases. Lung histopathology revealed severe APD in 31 cases, APD of moderate degree in 6 cases, and slight APD in 24 cases. 10 cases displayed pneumonia without APD. Necrotizing granulomatous inflammation was found in 2 cases, and in 4 cases showed nonspesific findings. The relationship between the duration and cause of hospitalization and the degree of APD was evaluated statistically. There was a weak correlation between APD and the hospitalization period according to the Spearmann correlation test.