Overview
What is the origin of acute respiratory distress syndrome (ARDS)?
How is acute respiratory distress syndrome (ARDS) defined?
How is early acute respiratory distress syndrome (ARDS) characterized?
What are the injuries that result in acute respiratory distress syndrome (ARDS)?
What injuries to the alveolar epithelium result in acute respiratory distress syndrome (ARDS)?
What is the role of neutrophils in the pathogenesis of acute respiratory distress syndrome (ARDS)?
How does acute respiratory distress syndrome (ARDS) progress following injury to alveoli?
How does acute respiratory distress syndrome (ARDS) cause hypoxemia?
What factors lead to mortality in acute phase of acute respiratory distress syndrome (ARDS)?
What are the common risk factors for acute respiratory distress syndrome (ARDS)?
What are the major risk factors for acute respiratory distress syndrome (ARDS)?
What are the genetic risk factors of acute respiratory distress syndrome (ARDS)?
Why is the incidence of acute respiratory distress syndrome (ARDS) difficult to quantify?
What is the incidence of acute respiratory distress syndrome (ARDS) in the US?
What is the global incidence of acute respiratory distress syndrome (ARDS)?
What are the age-related differences in incidence for acute respiratory distress syndrome (ARDS)?
How does the incidence of acute respiratory distress syndrome (ARDS) vary by sex?
What are the mortality rates for acute respiratory distress syndrome (ARDS)?
Which factors increase the mortality risk of acute respiratory distress syndrome (ARDS)?
What are the morbidities associated with acute respiratory distress syndrome (ARDS)?
What are some patient education resources for acute respiratory distress syndrome (ARDS)?
Presentation
What are the signs and symptoms of acute respiratory distress syndrome (ARDS)?
Which physical findings are characteristic of acute respiratory distress syndrome (ARDS)?
Which lung exam findings are characteristic of acute respiratory distress syndrome (ARDS)?
How is cardiogenic pulmonary edema distinguished from acute respiratory distress syndrome (ARDS)?
When is a tracheostomy indicated in the management of acute respiratory distress syndrome (ARDS)?
Which secondary infections are common in acute respiratory distress syndrome (ARDS)?
How are patients with acute respiratory distress syndrome (ARDS) weaned from mechanical ventilation?
Why is renal failure a frequent complication of acute respiratory distress syndrome (ARDS)?
What are potential complications of acute respiratory distress syndrome (ARDS)?
What are the long-term sequelae of acute respiratory distress syndrome (ARDS)?
DDX
What are the differential diagnoses for Acute Respiratory Distress Syndrome (ARDS)?
Workup
How is acute respiratory distress syndrome (ARDS) diagnosed?
How is cardiogenic pulmonary edema differentiated from acute respiratory distress syndrome (ARDS)?
What is the role of radiography in the evaluation of acute respiratory distress syndrome (ARDS)?
When are signs of recovery from acute respiratory distress syndrome (ARDS) seen on radiographs?
What is the role of CT scanning in the diagnosis of acute respiratory distress syndrome (ARDS)?
What is the role of echocardiography in the diagnosis of acute respiratory distress syndrome (ARDS)?
What is the role of bronchoscopy in the diagnosis of acute respiratory distress syndrome (ARDS)?
Which BAL fluid finding is characteristic of acute respiratory distress syndrome (ARDS)?
How is a culture obtained for the diagnosis of acute respiratory distress syndrome (ARDS)?
What are the histologic changes associated with acute respiratory distress syndrome (ARDS)?
Which biopsy findings are characteristic of acute respiratory distress syndrome (ARDS)?
Treatment
What is the role of corticosteroids in the treatment of acute respiratory distress syndrome (ARDS)?
What is the role of rescue therapies in the treatment of acute respiratory distress syndrome (ARDS)?
How are the underlying causes of acute respiratory distress syndrome (ARDS) managed?
How is a negative fluid balance facilitated in acute respiratory distress syndrome (ARDS)?
How is hypoxemia treated in acute respiratory distress syndrome (ARDS)?
What is the role of a tracheostomy in the treatment of acute respiratory distress syndrome (ARDS)?
What activity restrictions are used in the treatment of acute respiratory distress syndrome (ARDS)?
What are the transfer considerations for patients with acute respiratory distress syndrome (ARDS)?
How is acute respiratory distress syndrome (ARDS) prevented?
Medications
What is the role of medications in the treatment of acute respiratory distress syndrome (ARDS)?
Which medications are used in the treatment of acute respiratory distress syndrome (ARDS)?
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Anteroposterior portable chest radiograph in patient who had been in respiratory failure for 1 week with diagnosis of acute respiratory distress syndrome. Image shows endotracheal tube, left subclavian central venous catheter in superior vena cava, and bilateral patchy opacities in mostly middle and lower lung zones.
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Photomicrograph from patient with acute respiratory distress syndrome (ARDS). Image shows ARDS in exudative stage. Note hyaline membranes and loss of alveolar epithelium in this early stage of ARDS.
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Portable chest radiograph in a patient with acute respiratory distress syndrome. The condition evolved over approximately 1 week.
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Portable chest radiograph in a patient with acute respiratory distress syndrome. The condition evolved over approximately 1 week.
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Portable chest radiograph in a patient with acute respiratory distress syndrome. The condition evolved over approximately 1 week.
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Photomicrograph from a patient with acute respiratory distress syndrome (ARDS). This image shows ARDS in the early proliferative stage. Note the type 2 pneumocytic proliferation, with widening of the septa and interstitial fibroblast proliferation.
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Photomicrograph from a patient with acute respiratory distress syndrome (ARDS). This image shows ARDS in the late proliferative stage. Note the extensive fibroblast proliferation, with incorporation of the hyaline membranes.
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Chest radiograph in a patient with acute respiratory distress syndrome (ARDS). The patient was treated with perflubron, which is used for partial liquid ventilation.
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Portable chest radiograph. This image shows bilateral opacities that are suggestive of ARDS.
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Computed tomography scan in a patient with suspected acute respiratory distress syndrome (ARDS). This image was obtained at the cardiac level with mediastinal window settings and shows bilateral pleural effusions instead of diffuse bilateral lung consolidation. In addition, the presence of some compression atelectasis in the lower lobes is observed.
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High-resolution computed tomography scan in a patient with acute respiratory distress syndrome. This image demonstrates a small right pleural effusion, consolidation with air-bronchograms, and some ground-glass-appearing opacities. The findings indicate an alveolar process, in this case, alveolar damage.
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ARDS, subacute 4x: low power view of lung in the organizing phase of ARDS. There is compression of alveoli by proliferating interstitial fibrous tissue but occasional hyaline membranes are still visible. Photomicrograph courtesy of Rodolfo Laucirica, M.D
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ARDS, subacute 20x: higher power view of an alveolus (center) lined by hyaline membranes with proliferating interstitial fibroblasts to the left and right of center. Photomicrograph courtesy of Rodolfo Laucirica, M.D