Version May 2024
| Etiology | Clinical features | Diagnostic tests |
| Sepsis | Fever, hypotension, leukocytosis, lactic acidosis, infectious source | Appropriate clinical context and positive cultures |
| Aspiration pneumonitis | Witnessed or risk for aspiration, food, lipid laden macrophages, airway erythema on bronchoscopy | Presumptive diagnosis with negative cultures |
| Infectious pneumonia (including mycobacterial, viral, fungal, parasitic) | Productive cough, pleuritic pain, fever, leukocytosis, lobar consolidation or bilateral infiltrates in an immunosuppressed patient | Appropriate clinical context and positive respiratory cultures |
| Severe trauma and/or multiple fractures | History of trauma or fractures within the last week | Diagnosis is apparent |
| Pulmonary contusion | History of chest trauma (blunt or penetrating), chest pain | Presumptive diagnosis in the correct clinical context, negative cultures |
| Burns and smoke inhalation | Exposure to fire or smoke, cough, dyspnea, DIC, particulate matter on bronchoscopy, surface burns | Presumptive diagnosis in the correct clinical context, negative cultures |
| Transfusion related acute lung injury and massive transfusions | History of transfusion, dyspnea during or shortly after transfusion | Diagnosis of exclusion |
| HSCT¶ | History of HSCT | Diagnosis of exclusion |
| Pancreatitis | Abdominal pain, vomiting, risk factors (eg, gallstones, alcohol, viral infection) | Elevated amylase and lipase, with or without abnormal imaging |
| Inhalation injuries other than smoke (eg, near drowning, gases) | History of inhalation exposure (eg, chlorine gas) | Diagnosis of exclusion |
| Thoracic surgery (eg, post-cardiopulmonary bypass) or other major surgery | History of surgery, intraoperative ventilation, intraoperative transfusion | Diagnosis of exclusion |
| Drugs (chemotherapeutic agents, amiodarone, radiation) | New drugs or radiation exposure on history, lymphocytosis on lavage, lavage may have suggestive features of amiodarone toxicity ("foamy macrophages") but is nonspecific | Diagnosis of exclusion, lung biopsy occasionally helpful |
AEP: acute eosinophilic pneumonia; ARDS: acute respiratory distress syndrome; COP: cryptogenic organizing pneumonia; DAD: diffuse alveolar damage; DIC: disseminated intravascular coagulation; HSCT: hematopoietic stem cell transplant.
* Use of the term ARDS to describe conditions such as AEP or COP is somewhat controversial. However, some experts consider these a "subtype" of ARDS since they present in a similar fashion to ARDS, although the pathology of such entities is different from DAD, which is the classic pathology associated with ARDS. Similarly, while neurogenic pulmonary edema meets the definition of ARDS since it causes hypoxemia and bilateral infiltrates in the absence of pulmonary edema due to heart failure, the pathology and clinical course is likely different. Similarly, embolism of fat, air, and amniotic fluid may mimic ARDS but it is uncertain as to whether they cause ARDS.
¶ Many patients with HSCT may develop a form of lung injury after transplant, but the distinction between this and ARDS due to complications of HSCT (eg, pneumonia) is often unclear.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
