Impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome
- Mareike Gierhardt
- Oleg Pak
- Dieter Walmrath
- Werner Seeger
- Friedrich Grimminger
- Hossein A. Ghofrani
- Norbert Weissmann
- Matthias Hecker
- Natascha Sommer
DOIAbstract
Acute respiratory distress syndrome (ARDS) is a serious complication of severe systemic or local pulmonary inflammation, such as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ARDS is characterised by diffuse alveolar damage that leads to protein-rich pulmonary oedema, local alveolar hypoventilation and atelectasis. Inadequate perfusion of these areas is the main cause of hypoxaemia in ARDS. High perfusion in relation to ventilation (V/Q<1) and shunting (V/Q=0) is not only caused by impaired hypoxic pulmonary vasoconstriction but also redistribution of perfusion from obstructed lung vessels. Rebalancing the pulmonary vascular tone is a therapeutic challenge. Previous clinical trials on inhaled vasodilators...
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