Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- baixa saturação de oxigênio
- insuficiência respiratória aguda
Other diagnostic factors
- pacientes em estado crítico
- dispneia
- frequência respiratória elevada
- crepitações pulmonares
- baixa complacência pulmonar
- febre, tosse, dor torácica pleurítica
- escarro espumoso
Risk factors
- sepse
- aspiração
- pneumonia
- trauma grave
- transfusões sanguíneas
- transplante de pulmão
- pancreatite
- história de abuso de álcool
- queimaduras e inalação de fumaça
- afogamento
- uso de cigarros eletrônicos e similares
- Imunoterapia
- superdosagem de medicamentos
- tabagismo
Diagnostic tests
1st tests to order
- radiografia torácica
- gasometria arterial
- cultura de escarro
- hemocultura
- urocultura
- amilase e lipase
Tests to consider
- peptídeo natriurético do tipo B (PNB)
- ecocardiografia
- cateterismo da artéria pulmonar
- lavagem broncoalveolar ou aspirado endotraqueal
- tomografia computadorizada (TC) do tórax
- Ultrassonografia do pulmão
- exame viral
- biópsia pulmonar a céu aberto
Treatment algorithm
todos os pacientes
Contributors
Authors
Lorraine B. Ware, MD
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
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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