Which one of the following distinguishes ARDS (acute/adult respiratory distress syndrome) from cardiogenic pulmonary oedema?
Correct Answer: Normal pulmonary aerial pressure
Description: Cardiogenic pulmonary edema is characterised by increased pulmonary aerial pressure with evidence of increased intracardiac pressures(S3 gallop,elevated JVP,peripheral edema) which are absent in ARDS-pulmonary edema. The chest radiograph in cardiogenic edema shows an enlarged cardiac silhouette,vascular redistribution,interstitial thickening and perihilar alveolar infiltrates;pleural effusions are common.In ARDS-pulmonary edema,hea size is normal,alveolar infiltrates are distributed more uniformly throughout the lungs,and pleural effusions are uncommon. Finally,the hypoxaemia of cardiogenic pulmonary edema is largely due to V/Q mismatch and responds to athe administration of supplemental oxygen.In contrast,hypoxaemia in ARDS-pulmonary edema is due to intra pulmonary shunting and typically persists despite high concentrations of inhaled O2. Reference:Harrison's Medicine-20th edition,page no:2032
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