Coupon Accepted Successfully!


Open Flashcards


7 out of 7

Acute Lung Injury (ALI) is characterized by all except (PNQ)

A PaO2/FiO2<200mm Hg

B Bilateral interstitial infiltrates

C PCWP <18 mm Hg

D Normal Left atrial pressure

Ans. A

PaO2/FiO2 < 200mm Hg

Clinical features

1). Tachypnea; tachycardia; peripheral vasodilatation.

2). There may not be any clinical sign on chest auscultation.

'Acute Lung Injury' (ALI) is a milder disorder than ARDS and is characterized by PaO2/FiO2 of less than 300 mmHg.

3). ALI is a less severe disorders than ARDS but has the potential to evolve into ARDS. ALI can be differentiated from ARDS by the arterial PO2/FiO2 (Inspiratory O2 fraction) ratio.

(Ref. Hari-18th ed., Table 268.2 Pg- 2205)

Diagnostic Criteria



PaO2 / FiO2

≤ 300 mm Hg

≤200 mm Hg




Chest Radiograph

Bilateral alveolar or interstitial infiltrates

Bilateral alveolar or interstitial infiltrates

Absence of left atrial hypertension

PCWP ≤ 18 mmHg

No Clinical evidence of increased left atrial pressure

PCWP ≤ 18 mmHg

No Clinical evidence of increased left atrial pressure

Extra Edge:

1). ALI is associated with a PaO2/FiO2 ≤300

2). Bilateral alveolar interstitial infiltrates on Radiographs along with, hypoxemia and pulmonary shunting due to intra alveolar filling are characteristic features of both ALI and ARDS.

Extra Edge:

Diagnostic criteria of ARDS:

1). Acute onset.

2). CXR: bilateral infiltrates.

3). PCWP <18mmHg or a lack of clinical congestive heart failure.

4). Total thoracic compliance <30ml/cm H2O.

Extra Edge:

Management Admit to ICU; give supportive therapy; treat the underlying cause.

1). Respiratory support In early ARDS, continuous positive airway pressure (CPAP Q) with 40-60% oxygen may be adequate to maintain oxygenation. But most patients need mechanical ventilation Q.

Complications of endotracheal intubation and positive pressure mechanical ventilation include:

Pulmonary complications

Gastrointestinal complications


1). Barotrauma

2). Nosocomial pneumonia

3). Oxygen toxicity

4). Tracheal stenosis

5). Deconditioning of respiratory muscles

1). Stress ulceration

2). Mild to moderate cholestasis

1). Malnutrition

2). Decubitus ulcers

3). Venous thrombosis

4). Depression

2). For Sepsis - Give antibiotic

3). Nutritional support: with high fat, antioxidant formulations.

4). Steroids protect those at risk of fat embolization and with pneumocystosis and may improve outcome in subacute ARDS.

5). Prognosis Overall mortality is 50%-75%.