All of the following are direct causes of Acute lung injury, EXCEPT:
Correct Answer: Cardiopulmonary bypass with hea lung machine
Description: Acute lung injury can arise from direct injury to the lung parenchyma or from indirect systemic insults transmitted to the lung by the pulmonary circulation. Direct causes of acute lung injury are pneumonia, gastric aspiration, blunt chest trauma, near drowning, and toxic inhalations. Indirect causes of ALI are sepsis, large volume blood transfusion, massive tissue trauma, lung transplantation, reperfusion after cardiopulmonary bypass, drug overdose and pancreatitis. Diagnosis of ALI/ARDS is considered when: 1. An appropriate underlying cause is present 2. There is development of bilateral alveolar or interstitial infiltrates of acute onset( less than 72 hours) on a chest X ray. 3. Ratio of pulmonary aerial oxygen pressure/ Fi02 is less than 300 4. There is no clinical evidence of LVF or intravascular volume overload. Ref: The Washington Manual of Critical Care edited by Marin H. Kollef, page 55.
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