Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema.

Détails

ID Serval
serval:BIB_D0186E41E367
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema.
Périodique
Respiratory Physiology & Neurobiology
Auteur(s)
Sartori C., Allemann Y., Scherrer U.
ISSN
1569-9048
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
159
Numéro
3
Pages
338-349
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Résumé
Pulmonary edema is a problem of major clinical importance resulting from a persistent imbalance between forces that drive water into the airspace of the lung and the biological mechanisms for its removal. Here, we will review the fundamental mechanisms implicated in the regulation of alveolar fluid homeostasis. We will then describe the perturbations of pulmonary fluid homeostasis implicated in the pathogenesis of pulmonary edema in conditions associated with increased pulmonary capillary pressure, namely cardiogenic pulmonary edema and high-altitude pulmonary edema (HAPE), with particular emphasis on the latter that has provided important new insight into underlying mechanisms of pulmonary edema. We will provide evidence that impaired pulmonary endothelial and epithelial nitric oxide synthesis and/or bioavailability may represent a central underlying defect predisposing to exaggerated hypoxic pulmonary vasoconstriction, and, in turn, capillary stress failure and alveolar fluid flooding. We will then demonstrate that exaggerated pulmonary hypertension, while possibly a prerequisite, may not always be sufficient to cause HAPE, and how defective alveolar fluid clearance may represent a second important pathogenic mechanism. Finally, we will outline, how this new insight gained from studies in HAPE, may be translated into the management of pulmonary edema and hypoxemia related disease states in general.
Mots-clé
Altitude, Extracellular Fluid/metabolism, Humans, Pulmonary Alveoli/physiopathology, Pulmonary Edema/physiopathology, Water-Electrolyte Balance/physiology
Pubmed
Web of science
Création de la notice
22/02/2008 15:02
Dernière modification de la notice
20/08/2019 15:50
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