Analysis of extravascular lung water dynamics and exhaustive evaluation of pulmonary epithelial metabolites to establish a novel therapeutic approach for acute lung injury/ acute respiratory distress syndrome

急性呼吸窘迫综合征(ARDS)的特征是继发于肺血管通透性增加的急性肺水肿。虽然反映ARDS病理生理特征的ARDS诊断标准尚未确定，但我们通过前瞻性、多机构、观察性研究，利用肺血管通透性和血管外肺水含量的增加，建立了一个新的ARDS定量标准。我们还证明，根据柏林定义，ARDS的分期预示着血管外肺水量和肺血管通透性程度的增加。疾病进展的柏林阶段也与生理紊乱的严重程度有关，损伤相关的分子模式可能涉及ARDS的病理生理学。

Acute respiratory distress syndrome (ARDS) is characterized by acute pulmonary edema secondary to increased pulmonary vascular permeability. Although diagnostic criterion of ARDS reflecting the pathophysiological features of this condition has not been defined, we established a novel quantitative criterion of ARDS, using pulmonary vascular permeability combined with increased extravascular lung water content by a prospective, multi-institutional, observational study. We also demonstrated that the stages of ARDS by the Berlin definition predict increases in both the amount of extravascular lung water and the degree of pulmonary vascular permeability. The Berlin stages of disease progression are also associated with the severity of physiological derangements and damage-associated molecular patterns may be involved in the pathophysiology of ARDS.