Pulmonary microvascular fracture in a patient with acute respiratory distress syndrome*

Abstract

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. Case report. Adult intensive care unit of a university-affiliated teaching hospital. 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. Scanning electron micrographs of lung tissue, focusing on the internal alveolar surfaces. Multiple gross disruptions of the alveolar walls, suggestive of stress fractures. High-pressure mechanical ventilation may promote fracturing of the alveolar blood:airspace barrier.