Pathogenesis of Adult Respiratory distress syndrome • One of the above causes acts as an insult to the Capillary capillary endothelium or alveolar epithelium leading to disruption of capillary integrity with extravasation of fluid, fibrin, RBCs and WBCs into the lung interstitium and alveoli.• Tumour necrosis factor and IL-1 initiate the inflammatory response, these cytokines then stimulate IL-8 which perpetuates inflammation and coagulation. • There is severe hypoxia, the lungs stiffen and become less compliant resulting in difficulty with mechanical ventilation . • The pulmonary capillary wedge pressure is usually < 18 mmHg with no evidence of elevated left atrial pressure, pulmonary hypertension may occur as the interstitial edema leads to compression on the blood vessels. Clinical picture of ARDS Read more at :Pathogenesis and Clinical picture of ARDS