Abstract
Adult respiratory distress syndrome (ARDS) represents a common pathway of damage to the lungs by a wide variety of different agents. The important aetiological factors and mechanisms of lung injury are considered. Electron microscopic features as well as light microscopy are described. Factors that may modify the pathological picture are discussed. Probably the most important of these is oxygen. This gas is said to produce interstitial pulmonary fibrosis but this concept is once again questioned.

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