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Síndrome de dificultad respiratoria aguda (SDRA)

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 20 Aug 2025
Last updated: 31 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • baja saturación de oxígeno
  • insuficiencia respiratoria aguda
Full details

Other diagnostic factors

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

Risk factors

  • 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
Full details

Diagnostic investigations

1st investigations to order

  • radiografía de tórax
  • gasometría arterial
  • cultivo de esputo
  • hemocultivo
  • urocultivo
  • amilasa y lipasa
Full details

Investigations to consider

  • 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
Full details

Treatment algorithm

ACUTE

todos los pacientes

Contributors

Authors

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

Disclosures

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.

Acknowledgements

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

Disclosures

RF declares that he has no competing interests.

Peer reviewers

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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