RT Book, Section A1 Kasper, Dennis L. A1 Fauci, Anthony S. A1 Hauser, Stephen L. A1 Longo, Dan L. A1 Jameson, J. Larry A1 Loscalzo, Joseph SR Print(0) ID 1128781960 T1 Acute Respiratory Distress Syndrome T2 Harrison's Manual of Medicine, 19e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071828529 LK accessmedicine.mhmedical.com/content.aspx?aid=1128781960 RD 2024/03/29 AB Acute respiratory distress syndrome (ARDS) develops rapidly and includes severe dyspnea, diffuse pulmonary infiltrates, and hypoxemia; it typically causes respiratory failure. Key diagnostic criteria for ARDS include (1) diffuse bilateral pulmonary infiltrates on CXR; (2) PaO2 (arterial partial pressure of oxygen in mmHg)/FIO2 (inspired O2 fraction) ≤200 mmHg; and (3) absence of elevated left atrial pressure (pulmonary capillary wedge pressure ≤18 mmHg). Acute lung injury is a related but milder syndrome, with less profound hypoxemia (PaO2/FIO2 ≤300 mmHg), that can develop into ARDS. Although many medical and surgical conditions can cause ARDS, most cases (>80%) result from sepsis, bacterial pneumonia, trauma, multiple blood transfusions, gastric acid aspiration, and drug overdose. Individuals with more than one predisposing factor have a greater risk of developing ARDS. Other risk factors include older age, chronic alcohol abuse, metabolic acidosis, and overall severity of critical illness.