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KembaraXtra- Medicine – Acute Respiratory Distress Syndrome (ARDS)
Acute respiratory distress syndrome (ARDS) is a form of noncardiogenic pulmonary edema caused by acute alveolar injury leading to diffuse lung inflammation, interstitial and alveolar edema, severe hypoxemia, and respiratory failure. The hallmark is refractory hypoxemia due to disruption of the alveolar-capillary barrier, resulting in protein-rich alveolar edema. Earlier diagnostic criteria (AECC 1994) required acute onset, PaO₂/FiO₂ ≤200, bilateral infiltrates on chest radiograph, and no evidence of congestive heart failure (PAWP ≤18 mm Hg or no clinical evidence of elevated left atrial pressure). The 2012 Berlin definition refined this and requires: onset within 1 week of an insult or new/worsening respiratory symptoms; bilateral opacities on chest imaging not fully explained by effusions, lobar/lung collapse, or nodules; respiratory failure not fully explained by cardiac failure/fluid overload (objective assessment such as echocardiography if no clear ARDS risk factor); and oxygenation severity categorized by PaO₂/FiO₂ with PEEP/CPAP ≥5 cm H₂O (with altitude correction if >1000 m). Severity is mild (200
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