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Acute respiratory distress syndrome — ABIM Board MCQ

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HardPulmonary/Critical CareAcute respiratory distress syndromeABIM Board

A 51-year-old man with pancreatitis develops worsening hypoxemia. On volume assist-control ventilation, PaO2/FIO2 is 105, bilateral infiltrates are present, wedge pressure is not elevated, and plateau pressure is 34 cm H2O at tidal volume 8 mL/kg predicted body weight. Which of the following is the most likely cause?

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Correct answer: C — Diffuse inflammatory alveolar-capillary injury causing noncardiogenic edema

ARDS is caused by diffuse inflammatory alveolar-capillary barrier injury, producing noncardiogenic pulmonary edema, severe hypoxemia, and bilateral infiltrates without elevated left-sided filling pressures.

Reference: ATS/ESICM/SCCM ARDS Guideline; ARDSNet Trial