II. Definition

  1. Acute Respiratory Distress Syndrome (ARDS)
    1. Acute onset of Dyspnea, Tachypnea, Hypoxemia, and bilateral Interstitial Infiltrates that rapidly progresses to respiratory failure
  2. Acute Lung Injury (ALI)
    1. Slightly less severe form of ARDS in hospitalized patients with less severe Hypoxemia than ARDS

III. Epidemiology

  1. Incidence
    1. Acute Lung Injury (ALI)
      1. Adults: Up to 86 cases per 100,000 person years
      2. Children: 9.5 cases per 100,000 person years
    2. Acute Respiratory Distress Syndrome (ARDS)
      1. Adults: Up to 64 cases per 100,000 person years
      2. Children: 12.8 cases per 100,000 person years
  2. References
    1. Rubenfeld (2005) N Engl J Med 353(16): 1685-93
    2. Zimmerman (2009) Pediatrics 124(1): 87-95

IV. Pathophysiology

  1. Acute, bilateral, complete lung inflammation
    1. Onset 24-48 hours after major trauma or severe illness
    2. Variant of multi-system organ failure (e.g. Acute Tubular Necrosis, Disseminated Intravascular Coagulation)
  2. Development: Neutrophil mediated endothelial damage
    1. Inflammatory mediator proliferation leads to Neutrophil accumulation within the lung microcirculation
      1. Neutrophils activate and cross the vascular endothelium and the alveolar epithelium
      2. Neutrophils release proteases, cytokines, and reactive oxygen species
    2. Inflammatory mediator cause local destruction
      1. Vascular permeability increases to protein rich fluid
      2. Gaps form at the alveolar epithelial barrier
      3. Alveolar cell (type I and II) necrosis
    3. Local tissue effects ultimately decrease lung compliance and interfere with gas exchange
      1. Low-pressure pulmonary edema
      2. Hyaline membrane formation
      3. Surfactant loss
    4. Fibroblasts infiltrate region of inflammation
      1. Collagen deposition
      2. Fibrosis
      3. Disease progression
  3. Recovery
    1. Neutrophils are deactivated by anti-inflammatory cytokines
      1. Neutrophils undergo apoptosis and later phagocytosis
    2. Alveolar cells proliferate
      1. First Type II, which differentiate into type I
    3. Osmotic gradient reverses
      1. Draws fluid out of alveoli and back into lymphatics and lung microcirculation
    4. Macrophages and alveolar cells activity
      1. Remove protein depositions from the alveoli
  4. Models of pathogenesis
    1. ARDS is analogous to other system failures
      1. Disseminated Intravascular Coagulation (DIC)
      2. Acute Tubular Necrosis (ATN)
    2. Surfactant disorder
      1. Neonatal Respiratory Distress Syndrome
    3. Fibrosis
      1. Idiopathic Pulmonary Fibrosis (chronic)
    4. Granulation
      1. Healing superficial skin wound
    5. Microatelectasis

V. Risk factors

  1. Chronic lung disease
  2. Alcoholism
  3. Age over 65 years
  4. ICU admission (7% develop ALI or ARDS)
  5. Mechanical Ventilation (16% develop ALI or ARDS)

VI. Causes

  1. Direct lung injury
    1. Pneumonia (highest risk)
    2. Respiratory Syncytial Virus
    3. Gastric acid aspiration
    4. Pulmonary Contusion
    5. Fat embolism
    6. Toxic Inhalation Injury
      1. Smoke Inhalation
      2. Chlorine
      3. Nitrogen dioxide
      4. Phosgene
      5. Ammonia
      6. Cocaine
      7. Clove Cigarettes
    7. Near-drowning (high risk)
    8. Severe pulmonary Hemorrhage
    9. Oxygen Toxicity
  2. Indirect lung injury
    1. Sepsis (highest risk of ARDS - 79% of cases)
    2. Multiple trauma (high risk)
    3. Disseminated Intravascular Coagulation
    4. Cardiopulmonary bypass (CABG)
    5. Burn Injury
    6. Acute Pancreatitis
    7. Drug Overdose (Heroin, Cocaine)
    8. Transfusion reaction
    9. Ingestion
      1. Hydrocarbon ingestion
      2. Ethchlorvynol (Placidyl)
    10. Non-cardiac pulmonary edema
      1. High Altitude Pulmonary Edema
      2. Neurogenic pulmonary edema
      3. Heroin-induced pulmonary edema
    11. Infection (often in immunocompromised patients)
      1. Miliary Tuberculosis
      2. Pneumocystis carinii
      3. Diffuse fungal infection
        1. Histoplasmosis
        2. Blastomycosis
        3. Coccidioidomycosis
        4. Cryptococcosis

VII. Symptoms

  1. Onset within 24-72 hours of triggering event
  2. Progressive Dyspnea

VIII. Signs

IX. Labs: Arterial Blood Gas

  1. Critical for assessment
  2. Most sensitive for identifying ARDS early
  3. Large A-a Gradient

X. Imaging

  1. Chest XRay
    1. Early: Diffuse, bilateral Interstitial Infiltrates
    2. Later: Diffuse fluffy infiltrates (pulmonary edema)
    3. No cardiomegaly or Pleural Effusions
  2. Chest CT
    1. Acute Phase
      1. Bilateral alveolar opacities
      2. Air Bronchograms
      3. Bullae
      4. Pleural Effusions
    2. Fibroproliferative stage
      1. Bilateral reticular opacities
      2. Decreased Lung Volume
      3. Large bullae

XI. Diagnosis

  1. Criteria
    1. Acute onset
    2. Identifiable cause from above list
    3. Not due to Congestive Heart Failure
      1. Pulmonary artery wedge pressure <19 mmHg or
      2. No signs of left atrial Hypertension
    4. Hypoxemia despite Supplemental Oxygen
      1. See PaO2 to FIO2 ratios below
    5. Bilateral Pulmonary Infiltrates on Chest XRay
  2. Spectrum of lung injury based on PaO2/FIO2
    1. Interpretation regardless of PEEP
    2. Normal patient: 500 mmHg
    3. Acute Lung Injury: <300 mmHg
    4. Acute Respiratory Distress Syndrome: <200 mmHg
  3. References
    1. Bernard (1994) Am J Respir Crit Care Med 149:818-24

XII. Differential Diagnosis

  1. See Hypoxia
  2. Congestive Heart Failure
    1. ARDS is non-cardiogenic pulmonary edema
    2. Critical to distinguish ARDS from CHF, as CHF management is not effective in ARDS
      1. ARDS is managed with supportive care
      2. Avoid Furosemide and ACE Inhibitors in ARDS
    3. ARDS, in contrast to CHF
      1. Heart size is typically normal in ARDS (often difficult to distinguish)
      2. Left atrial Hypertension or volume overload are typically absent in ARDS
    4. CHF is often accompanied by
      1. Edema
      2. Jugular Venous Distention
      3. S3 gallup
      4. Increased ntBNP
  3. Pneumonia
    1. Pneumonia is typically accompanied by a fever, Pleuritic Chest Pain, productive cough and a localized infiltrate
    2. Many of these features can also be present in ARDS, but a constellation of these symptoms suggests Pneumonia
      1. Pneumonia is also the most common cause of ARDS so may be difficult to distinguish from ARDS
      2. Hypoxia that does not improve wtih Supplemental Oxygen suggests ARDS
  4. Atypical infection
    1. Tuberculosis
    2. Fungal Pneumonia (e.g. Blastomycosis or Coccidioidomycosis)
    3. Pneumocystis Pneumonia

XIII. Management: General (Supportive care)

  1. See Ventilatory Support below
  2. Identify and treat underlying cause
    1. Example: Treat site-specific infections (e.g. Pneumonia)
  3. Maximize nutritional status and fluid balance
    1. Conservative fluid therapy titrated down to lower Central Venous Pressures (shortens ICU stay)
    2. Enteral Nutrition started within 24 to 48 hours of ICU admission
    3. Eicosapentaenoic Acid (fish oil extract) effective
  4. Inotropic pressure support may be required
  5. Pulmonary artery catheters (and central venous catheters) are not routinely indicated
    1. Choose selectively in complicated fluid status, and then only by experienced clinicians
    2. Higher risk of complications without significantly improved outcomes
  6. Maintain adequate Sedation and analgesia
  7. Stress Ulcer prophylaxis
    1. Sucralfate 1 gram orally or via Nasogastric Tube four times daily or
    2. Ranitidine (e.g. Ranitidine 50 mg IV every 8 hours) or
    3. Proton Pump Inhibitor (e.g. Protonix 40 mg IV)
  8. Deep Vein Thrombosis Prevention
    1. Enoxaparin 40 mg SQ daily or
    2. Daltaeparin 5000 units SQ daily or
    3. Unfractionated Heparin 5000 units SQ twice daily
  9. Prone position reduces dependent consolidation
    1. Prone position requires adequate Sedation
    2. Prone position does not alter hemodynamic parameters
  10. Inhaled Beta Agonists appear effective
    1. Reduce Ventilatory pressures and increase oxygenation
  11. Corticosteroids have mixed outcome results
    1. Consult with a medical intensivist about use
    2. Some studies suggest early use of Methylprednisolone decreases days on mechanical Ventilator
    3. Other studies show possible benefit later in course
    4. No consistent benefit shown in terms of reduction in mortality
  12. Measures not proven effective
    1. Inhaled nitric oxide
    2. Aerosolized surfactant replacement
    3. N-Acetylcysteine (Mucomyst)
    4. Vasodilators (e.g. Nitroprusside, Hydralazine)
    5. Prophylactic antibiotics
    6. Prophylactic Chest Tubes
  13. Measures used in Congestive Heart Failure will not be effective in ARDS
    1. Furosemide will not be effective in ARDS
    2. ACE Inhibitors will not be effective for ARDS
    3. Nitroglycerin will not be effective for ARDS
  14. Experimental methods under current evaluation
    1. Liquid ventilation (lung filled with perfluorocarbon)

XIV. Management: Lung Protective Ventilator Strategy

  1. See Mechanical Ventilation
  2. Overall strategy
    1. Limiting barotrauma decreases mortality in ARDS
  3. Start with Tidal Volume at 4-6 ml/kg initially
    1. Much lower than Tidal Volume in other conditions (typically 10-15 ml/kg)
    2. Base Tidal Volume on Ideal Weight for height
  4. Lower FIO2 to avoid alveolar toxicity
    1. Titrate FIO2 down to 0.60 to keep O2 Sat at 88-95%
  5. Set PEEP for maximal alveolar recruitment
    1. Set PEEP >12 cm H2O
    2. Monitor for reduced Cardiac Output
  6. Allow some hypercapnia to reduce barotrauma risk (permissive hypercapnia)
    1. Lower minute volumes (lower Tidal Volume and rate)
    2. Titrate to PaCO2 of 50 to 77 mmHg (permissive hypercapnia)
    3. Titrate to pH of 7.20 to 7.30
  7. Maintain plateau pressure (inspiratory pressure) <30 cm H2O
  8. Other settings
    1. Inspiratory to expiratory ratio of 1:1 to 1:3
    2. Respiratory Rate up to 35 breaths per minute
  9. Adjuncts
    1. Consider Tracheostomy for prolonged intubation (anticipated >10 days)
    2. Mobilization therapy reduces days on Ventilator as well as days in ICU
  10. Weaning criteria
    1. Meeting oxygen requirements with non-invasive methods
    2. Hemodynamically stable
    3. Minute ventilation is 15 Liters or less
    4. Positive End-Expiratory Pressure (PEEP) is 5 cm H2O or less
    5. Tolerates 1-2 hour trials of spontaneous breathing
      1. Protects airway
      2. No agitation
      3. Remains hemodyanmically stable
      4. Oxygen Saturation maintained at 90% or greater
      5. Respiratory frequency to Tidal Volume ratio maintained at 105 or less
      6. Respiratory Rate does not exceed 35 breaths per minute

XV. Complications

  1. Nosocomial infection
  2. Pneumothorax (barotrauma related) in up to 41% of cases
  3. Gastrointestinal Bleeding (Stress Ulcer)
  4. Thromboembolism

XVI. Course

  1. ARDS presents within 12-24 hours of antecedent event
  2. ARDS patients intubated within 72 hours in 90% cases
  3. High mortality rate
    1. Short-term mortality (ICU: 37%, overall: 42%)
      1. Most deaths are due to multi-organ failure
      2. Refractory Hypoxemia accounts for 16% of deaths
    2. Long-term mortality in the first 3 years following ALI or ARDS
      1. Mechanical Ventilation was required: 57% three year mortality
      2. ICU admission not requiring ventilation: 38% three year mortality
      3. No ICU admission or ventilation: 15% three year mortality
      4. Wunsch (2010) JAMA 303(9): 849-56
  4. Typical hospital course
    1. ICU stay averages 16 days
    2. Hospital stay averages 26 days
  5. Predictors of better prognosis
    1. Those who survive first 2 weeks have better prognosis
    2. Age under 55 years
      1. Children under age 15 years have an overall mortality rate of 18% (contrast with 42% in adults)
      2. Zimmerman (2009) Pediatrics 124(1): 87-95
    3. Trauma related ARDS
  6. Predictors of poor prognosis
    1. Elderly (especially over age 70 years)
    2. Immunocompromised patients
    3. Chronic Liver Disease
    4. Increased dead space fraction

XVII. Management: Follow-Up ICU Stay

  1. Applies to over 100,000 survivors of ARDS in United States annually
  2. See Post-ICU Ambulatory Care
  3. See Myopathy Following ICU Admission
  4. Anticipate cognitive Impairment
  5. Anticipate lower quality of life
  6. Anticipate prolonged respiratory recovery period
    1. Even at 5 years, some residual pulmonary function deficit persists
  7. Mortality in first 3 years is very high (see above)
  8. Higher morbidity with prolonged Mechanical Ventilation and ICU stay
  9. Psychiatric illness is common following ARDS episode
    1. Major Depression: Up to 43% of patients
    2. Anxiety Disorder: Up to 48% of patients
    3. Posttraumatic Stress Disorder: Up to 35% of patients

Images: Related links to external sites (from Google)

Ontology: Respiratory Distress Syndrome, Adult (C0035222)

Definition (MSH) A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.
Definition (NCI) Progressive and life-threatening pulmonary distress in the absence of an underlying pulmonary condition, usually following major trauma or surgery. Cases of neonatal respiratory distress syndrome are not included in this definition.
Definition (NCI) A disorder characterized by progressive and life-threatening pulmonary distress in the absence of an underlying pulmonary condition, usually following major trauma or surgery.
Definition (CSP) fulminant pulmonary interstitial and alveolar edema resulting from diffuse infection, shock, or trauma of the lungs.
Concepts Disease or Syndrome (T047)
MSH D012128
ICD10 J80
SnomedCT 196154008, 67782005, 95437004, 155627006, 196150004, 266411000
English Shock-lung syndrome, Adult Respiratory Distress Syndrome, ARDS, Human, Human ARDS, Lung, Shock, Respiratory Distress Syndrome, Adult, Shock Lung, DISTRESS RESPIRATORY SYNDROME ADULTS, RESPIRATORY DISTRESS SYNDROME ADULT, SYNDROME ADULT RESPIRATORY DISTRESS, SYNDROME RESPIRATORY DISTRESS ADULT, ADULT RESPIRATORY DISTRESS SYNDR, ADULT RESPIRATORY STRESS SYNDROME, RESPIRATORY DISTRESS SYNDROME, ADULT, Respiratory distress syndrome, Adult, Respiratory distress syndrome, adult, SHOCK LUNG, WET LUNG SYNDROME, Adult respiratory distress syndrome, NOS, ARDS - Adult resp distr syndr, Acquired resp distress syndrom, Acute respiratory distress syndrome, Adult respiratory distr syndr, Pulm capillary leak syndrome, Wet-lung syndrome, adult, SYNDROME ADULT RESPIRATORY, shock lung, wet lung, adult respiratory distress syndrome (ARDS), adult respiratory distress syndrome (ARDS) (diagnosis), noncardiac pulmonary edema, adult respiratory distress syndrome, noncardiac pulmonary edema (diagnosis), Non-cardiogenic pulm edema, Non-cardiogenic pulm oedema, A.R.D.S., Adult respiratory distress syndr, Distress respiratory syndrome adults, Respiratory distress syndrome adult, Syndrome adult respiratory distress, Syndrome respiratory distress adult, Adult RDS, Adult respiratory stress syndrome, Syndrome adult respiratory, RESPIRATORY DISTRESS SYNDROME ACUTE, ADULT RESPIRATORY DISTRESS SYNDROME, ARDS, ADULT RESPIRATORY DISTRESS SYNDROME, Respiratory Distress Syndrome, Adult [Disease/Finding], a r d s, adult rds, adult hyaline membrane disease, a.r.d.s., ards, danang lung, non-cardiogenic pulmonary edema, adult respiratory syndrome, wet lung syndrome, ARDSs, Human, Acute Respiratory Distress Syndrome, Respiratory Distress Syndrome, Acute, ARDS, Adult respiratory distress syndrome, Congestive atelectasis, DaNang lung, Shock lung, Vietnam lung, ARDS - Adult respiratory distress syndrome, Acquired respiratory distress syndrome, Adult hyaline membrane disease, Pulmonary capillary leak syndrome, Non-cardiogenic pulmonary edema, Non-cardiogenic pulmonary oedema, Adult respiratory distress syndrome (disorder), Non-cardiogenic pulmonary edema (disorder), distress syndrome; respiratory, adult, distress; respiratory syndrome, adult, distress; respiratory, syndrome, adult, hyaline; disease, membrane, adult, lung; shock, respiratory distress; syndrome, adult, respiratory; distress, syndrome, adult, shock-lung; syndrome, shock; lung, syndrome; respiratory distress, adult, syndrome; shock-lung, Resp. distress synd. - adult, Respirat distress synd-adult
Portuguese PULMAO DE CHOQUE, Síndrome de dificuldade respiratória do adulto, Síndrome respiratória do adulto, Síndrome de dificuldade respiratória aguda, Pulmão de choque, Síndrome de stress respiratório do adulto, SIND DE DIFICULDADE RESPIRATORIA, SINDROME DE DIFICULDADE RESP DO A, Edema pulmonar não cardiogénico, Síndrome de sofrimento respiratório agudo, ARDS Humano, Pulmão de Choque, SDRA Humano, Síndrome da Angústia Respiratória do Adulto, Síndrome do Desconforto Respiratório Agudo, Síndrome do Desconforto Respiratório do Adulto, Síndrome do Desconforto Respiratório em Adultos
Italian Edema polmonare non cardiogeno, Sindrome da sofferenza respiratoria acuta, Sindrome da sofferenza respiratoria dell'adulto, Sindrome respiratoria dell'adulto, Sindrome da sofferenza respiratoria nell'adulto, Sindrome da sofferenza respiratoria, adulti, ARDS Umana, Sindrome da distress respiratorio acuto, Shock polmonare, Sindrome da distress respiratorio dell'adulto
Dutch schock long, ademhalingsnoodsyndroom bij volwassenen, ARDS, distress syndrome; respiratoir, volwassene, distress; respiratoir syndroom, volwassene, distress; respiratoir, syndroom, volwassene, hyaliene; aandoening, membraan, volwassene, long; shock, respiratoir; distress, syndroom, volwassene, respiratoire nood; syndroom, volwassene, shock-long; syndroom, shock; long, syndroom; respiratoire nood, volwassene, syndroom; shock-long, acuut ademhalingsnoodsyndroom, longoedeem van niet-cardiale oorsprong, ARDS, humaan, Adult respiratory distress syndrome (ARDS), Respiratory distress syndrome, adult (ARDS), Shock-long, Syndrome, respiratory distress, adult (ARDS), Syndrome, distress, respiratory, adult (ARDS), Acute respiratory distress syndrome, Adult respiratory distress syndrome, Respiratory distress syndrome, acute
French Choc au poumon, SDR chez l'adule, Syndrome de détresse respiratoire chez l'adulte, Syndr de détresse respiratoire de l'adulte, Syndrome de détresse respiratoire aiguë de l'adulte (SDRA), Syndrome de stress respiratoire de l'adulte, Syndrome respiratoire de l'adulte, POUMON DE CHOC, SYND DETRESSE RESPIRATOIRE, SYND. DE DETRESSE RESPIRATOIRE, Syndrome de détresse respiratoire aiguë, Oedème pulmonaire non cardiogénique, SDRA, Poumon de choc, Syndrome de détresse respiratoire aigüe, Syndrome de détresse respiratoire de l'adulte
German ARDS, A.R.D.S in Erwachsenen, respiratorisches Distress-Syndr in Erwachsenen, respiratorisches Stress-Syndrom in Erwachsenen, Syndrom respiratorisch in Erwachsenen, Distress-Syndrom respiratorisch in Erwachsenen, Syndrom respiratorischer Distress in Erwachsenen, non-kardiogenes Pulmonaloedem, respiratorisches Distress-Syndrom in Erwachsenen, Syndrom in Erwachsenen respiratorischer Distress, ATEMNOTSYNDROM BEIM ERWACHSENEN, ATEMNOTSYNDROM DES ERWACHSENEN, Atemnotsyndrom des Erwachsenen [ARDS], SCHOCKLUNGE, Akutes respiratorisches Distress - Syndrom, nicht-kardiogenes Lungenoedem, ARDS, humanes, Erwachsenen-Atemnotsyndrom, Schocklunge, Atemnot-Syndrom der Erwachsenen, Respiratory-Distress-Syndrom, Erwachsene
Spanish Síndrome de distrés respiratorio del adulto, Pulmón de shock, Síndrome de distrés respiratorio en el adulto, Síndrome respiratorio del adulto, S.D.R.A., SSR del adulto, Síndrome de distrés respiratorio en adultos, Síndrome de distress respiratorio del adulto, Síndrome de sufrimiento respiratorio del adulto, Adult respiratory distress syndrome, Respirat distress synd-adult, Resp. distress synd. - adult, SHOCK PULMONAR, SINDROME DIFICULTAD RESPIRAT. DEL, síndrome de distress respiratorio agudo del adulto, Pulmón en Choque, Pulmon en Choque, Pulmón en Shock, Pulmon en Shock, SDRA, distrés respiratorio, edema pulmonar no cardiogénico (trastorno), edema pulmonar no cardiogénico, pulmón de Vietnam, síndrome de dificultad respiratoria aguda del adulto (trastorno), síndrome de dificultad respiratoria aguda del adulto, síndrome de distrés respiratorio del adulto, Edema de pulmón no cardiogénico, Síndrome de sufrimiento respiratorio agudo, ARDS Humano, SDRA Humano, Síndrome Agudo de Dificultad Respiratoria, Síndrome de Dificultad Respiratoria Aguda, Síndrome de Dificultad Respiratoria del Adulto, SIRA Humano, Sindrome Agudo de Dificultad Respiratoria, Sindrome de Dificultad Respiratoria Aguda, Sindrome de Dificultad Respiratoria del Adulto
Japanese 非心原性肺水腫, ARDS, 成人呼吸症候群, 成人RDS, セイジンRDS, セイジンコキュウショウコウグン, ヒシンゲンセイハイスイシュ, ARDS, ショックハイ, キュウセイコキュウキュウハクショウコウグン, セイジンコキュウキュウハクショウコウグン, 急性呼吸窮迫症候群, 成人呼吸窮迫症候群, ヒトARDS, 呼吸窮迫症候群-成人型, 成人型呼吸窮迫症候群, 成人型RDS, ショック肺, ARDS-ヒト, 呼吸窮迫症候群-急性
Swedish Andnödssyndrom hos vuxna
Czech syndrom respirační tísně dospělých, ARDS, Plicní edém nekardiogenní, Syndrom respirační tísně dospělých, A.R.D.S., Nekardiogenní plicní edém, Adult RDS, Šoková plíce, Syndrom akutní respirační tísně
Finnish Aikuisen hengitysvaikeusoireyhtymä
Russian РЕСПИРАТОРНЫЙ ДИСТРЕСС-СИНДРОМ ВЗРОСЛЫХ, SHOKOVOE LEGKOE, DYKHATEL'NYKH RASSTROISTV SINDROM VZROSLYKH, RESPIRATORNYI DISTRESS-SINDROM VZROSLYKH, ATELEKTAZ ZASTOINYI, ДЫХАТЕЛЬНЫХ РАССТРОЙСТВ СИНДРОМ ВЗРОСЛЫХ, LEGKOE SHOKOVOE, VZROSLYKH DYKHATEL'NYKH RASSTROISTV SINDROM, АТЕЛЕКТАЗ ЗАСТОЙНЫЙ, ВЗРОСЛЫХ ДЫХАТЕЛЬНЫХ РАССТРОЙСТВ СИНДРОМ, ЛЕГКОЕ ШОКОВОЕ, ШОКОВОЕ ЛЕГКОЕ
Korean 성인성 호흡곤란 증후군
Croatian SINDROM RESPIRACIJSKOG DISTRESA ODRASLIH
Polish Zespół niewydolności oddechowej dorosłych, Zespół zaburzeń oddychania dorosłych, ARDS, Zespół ostrych zaburzeń oddychania, Zespół płuca wstrząsowego
Hungarian Nem-cardiogen pulmonalis oedema, Felnőttkori RDS, Felnőttkori respiratorikus distress syndroma, Acut respiratorikus distress syndroma, Felnőttkori respirációs distress syndroma, Felnőttkori respiratorikus syndroma, Tüdősokk, ARDS, Felnőttkori respiratorikus distress szindróma, Felnőttkori respiratoricus distress syndroma, Felnőtt respiratorikus distress syndroma

Ontology: Congestive atelectasis (C0205938)

Concepts Disease or Syndrome (T047)
MSH D001261 , D012128
English congestive atelectasis, Atelectases, Congestive Pulmonary, Congestive Pulmonary Atelectases, Atelectasis, Congestive, Atelectasis, Congestive Pulmonary, Congestive Atelectases, Pulmonary Atelectases, Congestive, Congestive Pulmonary Atelectasis, Pulmonary Atelectasis, Congestive, Congestive Atelectasis, Atelectases, Congestive, Congestive atelectasis
Spanish Atelectasia Congestiva
French Atélectasie pulmonaire congestive, Atélectasie congestive
Italian Atelectasia congestiva
German Atelektasen, Verschluß-
Portuguese Atelectasia Congestiva
Czech kongestivní plicní atelektáza
Dutch Atelectase, congestieve

Ontology: Acute Lung Injury (C0242488)

Definition (MSH) A condition of lung damage that is characterized by bilateral pulmonary infiltrates (PULMONARY EDEMA) rich in NEUTROPHILS, and in the absence of clinical HEART FAILURE. This can represent a spectrum of pulmonary lesions, endothelial and epithelial, due to numerous factors (physical, chemical, or biological).
Concepts Injury or Poisoning (T037)
MSH D055371 , D012128
SnomedCT 315345002
Spanish lesión pulmonar aguda, Lesión Aguda del Pulmón, Lesion Aguda del Pulmon, Lesión traumática pulmonar aguda, Lesión Pulmonar Aguda, Traumatismo Pulmonar Agudo, Lesion Pulmonar Aguda, Traumatismo Agudo del Pulmon, Traumatismo Agudo del Pulmón, lesión pulmonar aguda (trastorno), lesión traumática pulmonar aguda (trastorno), lesión traumática pulmonar aguda
English Acute Lung Injury, Lung Injuries, Acute, Acute Lung Injuries, Lung Injury, Acute, ACUTE LUNG INJ, LUNG INJ ACUTE, Acute Lung Injury [Disease/Finding], acute injury lung, acute lung injury, ALI - Acute lung injury, Acute lung injury, Acute lung injury (disorder)
French APA (Atteinte Pulmonaire Aigüe), Lésion pulmonaire aiguë, Atteinte pulmonaire aiguë, Atteinte pulmonaire aigüe, Lésion pulmonaire aigüe, Lésion grave du poumon
Italian Lesione polmonare acuta, Lesione acuta polmonare
Russian ЛЕГКИХ ПОВРЕЖДЕНИЕ ОСТРОЕ, LEGKIKH POVREZHDENIE OSTROE, OSTRAIA TRAVMA LEGKIKH, ОСТРАЯ ТРАВМА ЛЕГКИХ
German Lungenverletzung, akute, Akute Lungenverletzung
Swedish Akut lungskada
Portuguese Lesão pulmonar aguda, Traumatismo Agudo do Pulmão, Lesão Aguda do Pulmão, Lesão Pulmonar Aguda, Traumatismo Pulmonar Agudo
Dutch acuut longletsel, Acute longbeschadiging, Longbeschadiging, acute
Czech Akutní poranění plic, akutní poranění plic, plíce - akutní poranění, akutní poškození plic, plíce - akutní poškození
Japanese キュウセイハイソンショウ, 急性肺傷害, 急性肺損傷, 肺傷害-急性, 肺損傷-急性
Polish ALI, Ostry uraz płuc, Uszkodzenie płuc ostre, Ostre uszkodzenie płuc
Hungarian Acut tüdő sérülés