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Síndrome de dificultad respiratoria aguda (SDRA)

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
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Evidencia revisada por última vez: 1 Apr 2026
Tema actualizado por última vez: 31 May 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presencia de factores de riesgo
  • baja saturación de oxígeno
  • insuficiencia respiratoria aguda
Todos los datos

Otros factores de diagnóstico

  • paciente en estado crítico
  • disnea
  • aumento de la frecuencia respiratoria
  • crepitaciones pulmonares
  • distensibilidad pulmonar baja
  • fiebre, tos, dolor torácico pleurítico
  • esputo espumoso
Todos los datos

Factores de riesgo

  • sepsis
  • aspiración
  • neumonía
  • traumatismos graves
  • transfusiones de sangre
  • trasplante de pulmón
  • pancreatitis
  • antecedentes de abuso de alcohol
  • quemaduras e inhalación de humo
  • ahogamiento
  • uso del cigarrillo electrónico y de productos de vapeo
  • Inmunoterapia
  • sobredosis de fármacos
  • tabaquismo
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • radiografía de tórax
  • gasometría arterial
  • cultivo de esputo
  • hemocultivo
  • urocultivo
  • amilasa y lipasa
Todos los datos

Pruebas diagnósticas que deben considerarse

  • péptido natriurético cerebral (PNC)
  • ecocardiografía
  • cateterismo de la arteria pulmonar
  • lavado broncoalveolar o aspirado endotraqueal
  • exploración por tomografía computarizada (TC) del tórax
  • Ultrasonido de pulmón
  • pruebas virales
  • biopsia pulmonar abierta
Todos los datos

Algoritmo de tratamiento

Agudo

todos los pacientes

Colaboradores

Autores

Lorraine B. Ware, MD
Lorraine B. Ware

Ralph and Lulu Owen Professor of Medicine

Professor of 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

Divulgaciones

LBW has received consulting fees from Arrowhead, Akebia, Santhera, and Global Blood Therapeutics, all unrelated to the topic of this article. LBW has received research funding (to her institution) from the US National Institutes of Health, Boerhinger Ingelheim, and Genetech Inc., unrelated to the topic of this article. LBW holds stock in Virtuoso Surgical, unrelated to the topic of this article.

Agradecimentos

Dr Lorraine Ware would like to gratefully acknowledge Dr Richard Fremont, a previous contributor to this topic.

Declarações

RF declares that he has no competing interests.

Revisores

Michael A. Matthay, MD

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.

Timothy Evans, MBBS

Professor of Intensive Care Medicine

Royal Brompton Hospital

London

UK

Disclosures

TE declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Matthay MA, Arabi Y, Arroliga AC, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47.Full text  Abstract

Bos LDJ, Ware LB. Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes. Lancet. 2022 Oct 1;400(10358):1145-56.Full text  Abstract

Janz DR, Ware LB. Approach to the patient with the acute respiratory distress syndrome. Clin Chest Med. 2014 Dec;35(4):685-96.Full text  Abstract

Qadir N, Sahetya S, Munshi L, et al. An update on management of adult patients with acute respiratory distress syndrome: an official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2024 Jan 1;209(1):24-36.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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