lo - vicissitude

[ArchivalUser]

What is the ML cause of resp. failure in a 30 yr pt with sinus tachycardia, diffuse, extensive, bil interstitial, and alveolar infiltrates involving all lobes, and injuries including a laceration of the liver needed surgical repair, and spleen damage treated by splenectomy due to a motorcycle collision? He develops severe SOB a day after the operation, and on admission had temp 37.8, BP 90/60, P 120, R 28, received 8 units of packed RBC during the first half day, had traction applied for management of L femur™s and L humerus™ fractures. Exam: no jusgular venous distention, diffused crackles heard in all lung fields; Abd. exam: no abnormalities except for a midline operative incision, no edema nor cords of the LL extremities. Labs: hemoglobin 9, leu count 16500, platelet count 250000; serum: Na 140, K 4, HCO3 24, Cl 108, BUN 15, Cr. 1; art. Blood gas analysis on 60% oxy: pH 7.48, pCO2 35, pO2 48.

1. Pul. Embolism
2. CHF
3. Bacerial pneumonia
4. Aspiration pneu.
5. ARDS

[ArchivalUser]

5. ARDS......bilateral interstitial alveorla infiltrates and ........hypoxia

[ArchivalUser]

yes

[ArchivalUser]

features

[ArchivalUser]

bilateral infiltrate and pt is getting o2 but it is not doing any good --these thing are sufficient to indicate ards but respiratory alkalosis is not fitting the picture---

shock sepsis hemorrage massive trauma massive blood transfusion all can give rise to ards

[ArchivalUser]

any more comments

[ArchivalUser]

AGREE WITH POST-TRAUMATIC ARDS