[New aspects of the shock lung (author's transl)].

Using intravital lung biopsies and a shock model, which is based on preceding ultrastructural studies in humans, we could detect leucostasis and swelling of endothelial cells as a sign of the "lung in shock". These events are responsible for the resulting irreversible lung deterioration, though they are not accessible to clinical diagnosis. Therefore one must perform prophylactic treatment such as artificial ventilation, pharmacological influence on granulocyte functions including the release of lysosomal enzymes und oxygen radicals. In this way ARDS must be avoided, because there is still a mortality of about 60% with this syndrome.