A 54-year-old woman with septic shock from perforated diverticulitis is admitted and treated with broad-spectrum antibiotics and vasopressors. Two days later, she develops severe dyspnea requiring intubation. Vital signs show HR 118/min, RR 28/min, BP 92/58 mmHg, and SpO2 78% despite FiO2 100%. Chest radiograph reveals diffuse bilateral opacities. Arterial blood gas shows PaO2 55 mmHg with normal cardiac silhouette. Which diagnosis best explains her acute respiratory deterioration?
- A)Transudative pleural effusion from congestive heart failure
- B)Acute respiratory distress syndromeGABARITO
- C)Community acquired pneumonia
- D)Pulmonary edema due to left sided heart failure
- E)Pulmonary embolism
Explicação
Acute respiratory distress syndrome is correct. A major inflammatory insult followed by diffuse bilateral infiltrates and refractory hypoxemia is classic for ARDS. The underlying lesion is diffuse alveolar damage with protein rich hyaline membranes and severe ... Ver explicação completa e trilha adaptativa →