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. 1985 Dec;40(12):915–919. doi: 10.1136/thx.40.12.915

Cavitating lung infarction after bland pulmonary thromboembolism in patients with the adult respiratory distress syndrome.

S Redline, J F Tomashefski Jr, M D Altose
PMCID: PMC460226  PMID: 4095672

Abstract

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. COKE L. R., DUNDEE J. C. Cavitation in bland infarcts of the lung. Can Med Assoc J. 1955 Jun 15;72(12):907–910. [PMC free article] [PubMed] [Google Scholar]
  2. FREIMAN D. G., SUYEMOTO J., WESSLER S. FREQUENCY OF PULMONARY THROMBOEMBOLISM IN MAN. N Engl J Med. 1965 Jun 17;272:1278–1280. doi: 10.1056/NEJM196506172722406. [DOI] [PubMed] [Google Scholar]
  3. Goodman D. J., Rider A. K., Billingham M. E., Schroeder J. S. Thromboembolic complications with the indwelling balloon-tipped pulmonary arterial catheter. N Engl J Med. 1974 Oct 10;291(15):777–777. doi: 10.1056/NEJM197410102911507. [DOI] [PubMed] [Google Scholar]
  4. Grieco M. H., Ryan S. F. Aseptic cavitary pulmonary infarction. Am J Med. 1968 Nov;45(5):811–816. doi: 10.1016/0002-9343(68)90215-5. [DOI] [PubMed] [Google Scholar]
  5. HARVEY J. C., SABISTON D. C. Empyema as a complication of bland pulmonary infarction: consideration of the problem and report of five cases. Ann Intern Med. 1954 Feb;40(2):285–289. doi: 10.7326/0003-4819-40-2-285. [DOI] [PubMed] [Google Scholar]
  6. Hall F. M., Salzman E. W., Ellis B. I., Kurland G. S. Pneumothorax complicating aseptic cavitating pulmonary infarction. Chest. 1977 Aug;72(2):232–234. doi: 10.1378/chest.72.2.232. [DOI] [PubMed] [Google Scholar]
  7. Moser K. M. Pulmonary embolism. Am Rev Respir Dis. 1977 May;115(5):829–852. doi: 10.1164/arrd.1977.115.5.829. [DOI] [PubMed] [Google Scholar]
  8. Mundth E. D., Foley F. D., Austen W. G. Pneumothorax as a complication of pulmonary infarct in patients on positive pressure respiratory assistance. J Thorac Cardiovasc Surg. 1965 Oct;50(4):555–560. [PubMed] [Google Scholar]
  9. Schneider R. C., Zapol W. M., Carvalho A. C. Platelet consumption and sequestration in severe acute respiratory failure. Am Rev Respir Dis. 1980 Sep;122(3):445–451. doi: 10.1164/arrd.1980.122.3.445. [DOI] [PubMed] [Google Scholar]
  10. Snow R. L., Davies P., Pontoppidan H., Zapol W. M., Reid L. Pulmonary vascular remodeling in adult respiratory distress syndrome. Am Rev Respir Dis. 1982 Nov;126(5):887–892. doi: 10.1164/arrd.1982.126.5.887. [DOI] [PubMed] [Google Scholar]
  11. Steier M., Ching N., Roberts E. B., Nealon T. F., Jr Pneumothorax complicating continuous ventilatory support. J Thorac Cardiovasc Surg. 1974 Jan;67(1):17–23. [PubMed] [Google Scholar]
  12. Tomashefski J. F., Jr, Davies P., Boggis C., Greene R., Zapol W. M., Reid L. M. The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol. 1983 Jul;112(1):112–126. [PMC free article] [PubMed] [Google Scholar]

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