RT Book, Section
A1 Dahdel, Maher
A1 Dellinger, R. Phillip
A2 Lee, Kiwon
SR Print(0)
ID 1101645142
T1 Acute Respiratory Distress Syndrome
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101645142
RD 2024/04/23
AB A  63-year-old  man  with  no  past  medical  history  presented  with  a  3-day  history  of  productive  cough,  hemoptysis,  fever,  and  shortness  of  breath.  In  the  emergency  department  (ED)  the  patient  was  mildly  hypotensive  and  in  severe  respiratory  distress,  which  required  immediate  intubation  and  initiation  of  mechanical  ventilation.  His  laboratory  workup  revealed  leukocytosis,  mild  renal  insufficiency,  and  elevated  serum  lactate.  His  chest  radiograph  revealed  dense  consolidation  in  the  right  lower  lung  field  with  bilateral  patchy  infiltrates.  The  patient  continued  to  be  profoundly  hypoxemic  despite  incremental  increases  in  the  mechanical  ventilation  support.This  is  unfortunately  a  common  clinical  scenario  for  severe  community-acquired  pneumonia  with  associated  sepsis  and  acute  respiratory  distress  syndrome.  In  this  chapter  we  will:Review  the  definitions,  etiologies,  and  clinical  aspects  of  acute  respiratory  distress  syndrome  (ARDS).Describe  ventilator-induced  lung  injury  and  how  it  can  be  minimized.Review  the  role  of  steroid  therapy  and  fluid  management  in  ARDS.Review  rescue  strategies  that  may  be  considered  in  selected  patients  with  ARDS.Describe  outcome  of  ARDS  survivors.Review  neurogenic  pulmonary  edema.Review  the  effect  of  positive  ventilation  on  cerebral  perfusion.