Chest radiograph revealing diffuse bilateral airspace disease ("pulmonary edema"). What is the common
Hypoxemia that is difficult to correct with oxygen supplementation.
Hemodynamic evidence of a pulmonary artery occlusion (wedge) pressure < 18 mm Hg.
Thoracic static compliance less than 40 mL/cm of water
What clinical conditions did this patient experience that are common risk factors associated with ARDS?
Patients who have nearly drowned can develop ARDS. It is slightly more common to see ARDS with a salt water aspiration. The onset of symptoms may be slow. Lung infiltrates and the hypoxia are not usually seen until 12-24 hours of the accident.
The aspiration of the water is considered to be damaging to the lung tissue, and then results in situation where the osmotic gradient prefers the movement of water into the lung.
V/Q mismatch associated with ARDS? What is the cause of hypoxemia in ARDS?
And how is it treated? What is the clinical significance of static compliance? How is decreased static compliance demonstrated in the patient's case?
ARDS begins due to some sort of insult to the epithelium of the alveoli and the vascular endothelium, which allows increased pulmonary permeability to plasma and inflammatory mediators, which then pour into the interstitial and alveolar spaces. The resulting damage to the surfactant producing cells and the presence of the protein rich transudate within the alveoli leads to a decrease in the productions and function of pulmonary surfactant. This in itself will cause areas of micoatelectasis and impaired gas exchange.
These
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