Acute respiratory distress syndrome ARDS

• Facts:
  Form of noncardiogenic pulmonary edema
  Endothelial injury, leakage of fluid from capillaries
  Fluid fills interstitial spaces and alveoli
  Results in intrapulmonary shunting
  Mortality of 30-40%
• History / PE:
  Noncardiogenic pulmonary edema
  Refractory hypoxemia
• Diagnosis:
  Acute onset
  PaO2 / FiO2 < 200
  Diffuse bilateral pulmonary infiltration
  PCWP < 18 mmHg (no evidence of cardiac origin)
• Treatment:
  Ventilator with PEEP
• Associated With:
  Endothelial injury
  Hyaline membrane formation
  Alveolar collapse
  Sepsis
  Severe bleeding
• Differential Diagnosis:
  Iatrogenic pulmonary edema (elevated PCWP)