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Acute Respiratory Distress Syndrome – ARDS: Clinical Cheat Sheet

An acute diffuse, inflammatory lung injury, leading to
ARDS: Clinical ... congestion with hypoxemia ... edema must be present ... be detected on CT ... or CXR ● PaO2/
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
: Atelectasis, ARDS ... Edema, Atelectasis ... , Obstructive Lung ... , Interstitial Lung ... #Hypoxia #hypoxemia
ARDS/VALI progression over the course of 1 week 
 (a) Day 1 - No pathological findings.
ARDS/VALI progression ... involvement, with “white lung ... oedema due to heart ... #Clinical #Radiology ... #CXR #ChestXRay
On the left another patient with alveolar edema at admission, which resolved after treatment.
When you scroll
with alveolar edema ... #Clinical #Radiology ... #CXR #CHF #Alveolar ... #Pulmonary #Edema ... #AlveolarEdema
Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS) 
- Respiratory symptoms must have begun within one
week of a known clinical ... edema must be present ... on a chest radiograph ... computed tomographic (CT ... lobar collapse, lung
Noncardiogenic Pulmonary Edema - Differential Diagnosis Framework

NCPE Pathophysiology:
Noncardiogenic pulmonary edema occurs because of excessive pulmonary capillary
ischemic changes CXR ... respiratory distress syndrome ... (ARDS) • Opioid ... Transfusion-related acute lung ... #diagnosis #cardiology
Notice that even within each lobe there is a gravity dependent difference in density.
This is only
capillary leak like in ARDS ... #Clinical #Radiology ... #CTChest #CHF # ... Alveolar #Pulmonary ... #Edema #AlveolarEdema
Crazy Paving on Chest CT
 • Thickened interlobular septa in a background of diffuse GGO's.
 •
Crazy Paving on Chest ... DDx: PAP, pulm edema ... pna, pulm hge, ARDS ... #Lung #Pulmonary ... #clinical
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
supplying the lung ... In daily clinical ... during a period of CHF ... #Clinical #Radiology ... #CXR #CHF #Cephalization
Pulmonary Infections in HIV-AIDS
Bacterial: 
 • No organism identified, Strep pneumoniae, H. influenzae, S.aureus, Streptococcus Grp
embolism, Pulm edema ... failure, COPD, Lung ... Evaluation: Imaging (CXR ... +/- High res CT ... chest scan), CBC