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Is It Really ARDS?
- Recent literature suggests that the incidence of ARDS in intubated ED patients may be as high as 10%.
- The Berlin Definition of ARDS includes the acute onset of bliateral opacities (CXR or chest CT) that is not fully explained by pulmonary edema or fluid overload.
- Emergency physicians and Intensivists are well versed in lung-protective ventilator settings for patients with ARDS.
- However, several diseases can appear simliar to ARDS and may require different ventilator strategies and treatments.
- In the absence of clinical risk factors for ARDS (e.g., sepsis, trauma), consider the following in your differential:
- Idiopathic pulmonary fibrosis
- Interstitial pneumonitis
- Granulomatosis with polyangitis (Wegener's)
- Diffuse alveolar hemorrhage
- Goodpasture's syndrome
References
Guerin C, et al. The ten diseases that look like ARDS. Intensive Care Med 2015; 41:1099-1102.