Last reviewed: April 2018
Last updated: April  2018

Summary

Definition

History and exam

Key diagnostic factors

  • low oxygen saturation
  • acute respiratory failure

Other diagnostic factors

  • critically ill patient
  • dyspnea
  • increased respiratory rate
  • pulmonary crepitations
  • low lung compliance
  • fever, cough, pleuritic chest pain
  • frothy sputum

Risk factors

  • sepsis
  • aspiration
  • pneumonia
  • severe trauma
  • blood transfusions
  • lung transplantation
  • pancreatitis
  • history of alcohol misuse
  • burns and smoke inhalation
  • drowning
  • drug overdose
  • cigarette smoking

Diagnostic investigations

1st investigations to order

  • chest x-ray (CXR)
  • arterial blood gases
  • sputum culture
  • blood culture
  • urine culture
  • amylase and lipase
Full details

Investigations to consider

  • brain natriuretic peptide (BNP)
  • echocardiogram
  • pulmonary artery catheterization
  • bronchoalveolar lavage or endotracheal aspirate
  • CT scan of the thorax
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Lorraine Ware

Professor of Medicine and Pathology, Microbiology and Immunology

Director

Vanderbilt Medical Scholars Program

Division of Allergy, Pulmonary and Critical Care Medicine

Department of Medicine

Vanderbilt University School of Medicine

Nashville

TN

Disclosures

LW declares that she has no competing interests.

Dr Lorraine Ware would like to gratefully acknowledge Dr Richard Fremont, a previous contributor to this monograph. RF declares that he has no competing interests.

Peer reviewers VIEW ALL

Director of Medicine Critical Care Fellowship

Department of Anesthesia and Perioperative Care

University of California San Francisco

CA

Disclosures

MAM declares that he has no competing interests.

Professor of Intensive Care Medicine

Royal Brompton Hospital

London

UK

Disclosures

TE declares that he has no competing interests.

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