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Because patients with ARDS experience substantially reduced lung volumes caused by alveolar damage, atelectasis, and alveolar edema, the use of large mechanical tidal volumes are to be avoided to prevent over-distension of the lungs and volutrauma.
Qualitatively, all alterations characterizing the exudative phase of the histopathologic condition termed diffuse alveolar damage were identifiable, with intense congestion of the alveolar capillaries, marginated intracapillary neutrophils, necrosis of the alveolar epithelium, interstitial and alveolar edema, hyaline membranes, and invasion of the alveoli by (mostly) mononucleate cells.
Alveolar edema may be indistinguishable from hemorrhage or diffuse pneumonia.