Redline S, Tomashefski J F, Altose M D
Thorax. 1985 Dec;40(12):915-9. doi: 10.1136/thx.40.12.915.
During one year five patients were observed with the adult respiratory distress syndrome who were found at necropsy to have cavitated lung infarcts following bland (non-infected) pulmonary thromboembolism. There were three instances of bronchopleural fistula and in one person a tension pneumothorax was the immediate cause of death. Four of the five patients had severe lung infections. In all patients airway pressure was raised as a result of positive pressure mechanical ventilation. It is postulated that diffuse microvascular injury, bacterial pneumonia, and high airway pressures may be important factors predisposing patients with adult respiratory distress syndrome to develop lung necrosis, cavitation, and bronchopleural fistula after bland pulmonary thromboembolism. This complication may occur more frequently than has been previously recognised.
在一年时间里，观察到5例成人呼吸窘迫综合征患者，尸检发现他们在发生单纯性（非感染性）肺血栓栓塞后出现了肺梗死空洞。有3例发生支气管胸膜瘘，1例患者因张力性气胸为直接死因。5例患者中有4例发生严重肺部感染。所有患者均因正压机械通气导致气道压力升高。据推测，弥漫性微血管损伤、细菌性肺炎和高气道压力可能是促使成人呼吸窘迫综合征患者在单纯性肺血栓栓塞后发生肺坏死、空洞形成和支气管胸膜瘘的重要因素。这种并发症的发生可能比以往认识到的更为频繁。
