Diffuse alveolar damage is a histological pattern in lung disease. It is seen in acute respiratory distress syndrome (ARDS), transfusion related acute lung injury (TRALI) and acute interstitial pneumonia (AIP). Diffuse alveolar damage is a histological pattern in lung disease. It is seen in acute respiratory distress syndrome (ARDS), transfusion related acute lung injury (TRALI) and acute interstitial pneumonia (AIP). Diffuse alveolar damage is associated primarily with ARDS and TRALI in adults, and hyaline membrane disease in neonates.It is most commonly associated with infection. Diagnosis of ARDS is based on clinical manifestation and its severity is evaluated with ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FIO2). It is a common biopsy finding. Through histology, diffuse alveolar damage goes through several stages: