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.
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.

Extensive, diffuse bilateral fluffy infiltrates.
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.
The outcome of ARDS is a function of underlying cause.
± 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 ?
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
Mechanical ventilation in acute lung injury and ARDS: Tidal volume reduction.
Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review.
Role of oxidant stress in the adult respiratory distress syndrome: evaluation of a novel antioxidant strategy in a porcine model of endotoxin-induced acute lung injury.
In contrast to the well-established link between alcohol abuse and acute lung injury, the existence of an independent connection between lung function or chronic airway disease and alcohol consumption has been controversial:
The researchers also found evidence of an "aberrant immune response" in the lungs of some of the patients, which "suggests that an overly vigorous host inflammatory response triggered by the viral infection may spill over to and damage lung tissue, causing acute lung injury and fatal respiratory failure," said John Heffner, a former president of the American Thoracic Society .
Acute and severe pulmonary hypertension, as is commonly found in acute lung injury (mean pulmonary artery pressures in the region of 40-45 mmHg), (1) appeared not overtly due to spasm, as sildenafil (by mouth) did not decrease the pressure or improve the right heart output.
2] ratio in patients with acute lung injury or ARDS.
At a meeting of the FDA's Blood Products Advisory Committee in April, the panel agreed in a 13 to 0 vote that the use of predominantly male plasma for transfusions would reduce the incidence of transfusion-related acute lung injury (TRALI), the leading cause of transfusion-related deaths reported to the FDA over the past 3 years.
IVIG has rarely been associated with transfusion-related acute lung injury.
The Japanese Red Cross Society conducted the first study in Japan on the complication known as transfusion-related acute lung injury, or TRALI, based on international diagnosis standards.
Initial findings show that CPAP results in lower indicators of acute lung injury than mechanical ventilation during the first two hours of life.

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