AUTHOR=Hülsmann Swen , Khabbazzadeh Sepideh , Meissner Konrad , Quintel Michael 

TITLE=A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome

JOURNAL=Frontiers in Physiology

VOLUME=Volume 11 - 2020

YEAR=2021

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.588248

DOI=10.3389/fphys.2020.588248

ISSN=1664-042X

ABSTRACT=The acute respiratory distress syndrome (ARDS) represents an acute diffuse inflammation of the lungs triggered by different causes uniformly leading to a non-cardiogenic pulmonary edema with inhomogeneous densities in lung X-ray and lung CT scan and, acute hypoxemia. Edema formation results in “heavy” lungs inducing loss of compliance and the need to spend more energy to “move” the lungs. Consequently, an ARDS patient, as long as breathing spontaneously, has an increased respiratory drive to ensure adequate oxygenation and, CO2 removal. One would expect that once the blood gases get back to “physiological” values the respiratory drive would normalize and the breathing effort return to its initial status. However, in many ARDS patients this is not the case, their respiratory drive appears to be up-regulated and fully or at least partially detached from the blood gas status. Strikingly, similar alteration of the respiratory drive can be seen in patients suffering from SARS, especially SARS-Covid-19. We hypothesize that alterations of Renin-Angiotensin-System (RAS) related to the pathophysiology of ARDS and SARS are involved in this dysregulation of chemo-sensitive control of breathing.