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  • • Hypoxemia

    • Hypercarbia

    • Pulmonary edema (pulmonary capillary wedge pressure < 18 mm Hg)

    • Absence of other causes

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Epidemiology

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  • • Often follows shock/trauma/sepsis

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Symptoms and Signs

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  • • Hypoxemia

    • Hypercarbia

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Imaging Findings

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  • • Diffuse bilateral pulmonary infiltrates

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  • • Typically follows shock and either trauma or sepsis

    • ARDS typically develops 24 h after the resuscitation from the initial insult

    • Diagnosis may be complicated by the presence of other potential causes of hypoxemia

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  • • ABG measurements

    • Chest films

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  • • Ventilator management (positive end-expiratory pressure, inspiratory reserve volume)

    • Diuresis

    • Treatment of inciting cause

    • Transfusion

    • Proning

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Treatment Monitoring

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  • • Invasive monitoring (pulmonary artery catheter)

    • Serial arterial blood gas measurements

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Prognosis

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  • • Determined by etiology

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References

Bulger EM et al. Current clinical options for the treatment and management of acute respiratory distress syndrome. J Trauma. 2000;48:562.  [PubMed: 10744307]
The Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342:1301.
Chastre J et al: Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 2003;290:2588.  [PubMed: 14625336]

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