Is shock-induced lung fibrosis reversible? A report on recovery from "shock-lung".

As the consequence of a road accident a 19-year-old man developed respiratory insufficiency. Radiology and gas analysis revealed signs of "shock-lung". Morphometric analysis of a punch biopsy from the lung confirmed the diagnosis. Gas exchange grew worse in spite of conventional treatment. At the end of the third week after the trauma the maintenance of a highly negative fluid balance and the administration of high doses of corticoids were given a trial. The patient recovered. Although no functional pulmonary deficiencies remained, years later the patient still shows radiological evidence of extensive scarring. The lung parenchyma is intact, as judged by morphometric examination. This case shows that patients with "shock lung" can recover, but scars in the extrapulmonary space can remain, even though the lung parenchyma returns to normal.