acute lung injury


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adult respiratory distress syndrome

A condition due to a diffuse infiltrative process in the lungs, which affects ±150,000/year (US), and is characterised by acute pulmonary oedema and respiratory failure, poor oxygenation, increased functional residual capacity and decreased compliance; ARDS may accompany various medical and surgical conditions, and may be associated with interstitial pneumonitis—usual, desquamative and lymphoid types.
 
Aetiology
Gram-negative sepsis, pneumonia, shock, gastric acid aspiration, trauma, drug overdose, toxic gas (chlorine, NO2, smoke) exposure, severe metabolic derangement, pancreatitis.
 
Clinical findings
A 6–24-hour latency period is followed by hypoxia, decreased aeration, dyspnoea, severe SOB and “stiff” lungs—i.e., decreased pulmonary compliance.

Imaging
Extensive, diffuse bilateral fluffy infiltrates.
 
Management
Nitric oxide (NO), 18 ppm, may reduce mean pulmonary artery pressure; 37 to 30 mm Hg, may reduce intrapulmonary shunting (36% to 31%), increase ratio of partial pressure of arterial O2 to inspired O2 (PaO2/FiO2), an index of arterial oxygenation efficiency (±152 to ±199); other management strategies include PEEP.
 
Prognosis
The outcome of ARDS is a function of underlying cause.
 
Mortality
± 60%, the cause of death has shifted from hypoxia to multiple organ failure.

a·cute lung in·ju·ry

(ă-kyūt' lŭng in'jŭr-ē)
Any acute decline in lung function of sudden onset, whether traumatic or related to disease state; may be life threatening.

acute lung injury

Abbreviation: ALI.
A clinically severe, sudden decline in lung function, marked by infiltrates in both lung fields and significantly diminished arterial oxygen saturation. There is no evidence that the condition is caused by left-sided heart failure. The disease is similar to adult respiratory distress syndrome (ARDS). Like ARDS, ALI may be life threatening. ALI is distinguished from ARDS by the severity of hypoxemia. ALI = PaO2/FIO2 ratio of < 300, ARDS = PaO2/FIO2 < 200.
See also: injury
References in periodicals archive ?
Intraoperative ventilator settings and acute lung injury after elective surgery: a nested case control study.
Interleukin-18 levels reflect the long-term prognosis of acute lung injury and acute respiratory distress syndrome.
However, this ideal will be impossible to achieve in any meaningful time-frame and it therefore is critical to identify, test, and validate therapeutic strategies that can limit the morbidity and mortality of alcohol-related diseases, including acute lung injury and pneumonia.
2012) The effect of post-treatment N-acetylcysteine in LPS-induced acute lung injury of rats.
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1 Most common minor and major complications in this review were respectively allergic reactions (21%) and transfusion-associated acute lung injury (27%).
Tidal volume reduction in patients with acute lung injury when plateau pressures are not high.
Indeed, in the case of a single lung transplant there is the potential for dramatically different types of acute lung injury in both the transplanted as well as the native lung unit.
The report provides a snapshot of the global therapeutic landscape of Acute Lung Injury
These cases of acute lung injury were managed on inhaled oxygen and all survived.
The purpose of this article is to explore the management of coexisting brain insult and acute lung injury to help guide clinicians in balancing what may appear to be competing goals.
While the underlying mechanism for this effect remains unknown, CF has been reported to activate Nrf2, a transcription factor that is critical in protecting from various inflammatory lung diseases including acute lung injury (ALI).

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