Acute Respiratory Distress Syndrome Risk Factors

 

(1) Sepsis - both of the following:

(1a) 2 or more of the following 5 factors

(1a1) core temperature < 36°C or > 38.5°C

(1a2) white blood cell count > 12,000 per µL or < 3,500 per µL or > 20% immature forms

(1a3) one blood culture positive for a common pathogen

(1a4) a strongly suspected site of infection from which a known pathogen was cultured

(1a5) gross pus in a closed space,

(1b) 1 or more of the following 3 factors:

(1b1) systemic arterial hypotension for at least 2 hours (systolic blood pressure < 85 mm Hg, or > 40 mm Hg below the base line value, or need for inotropic drugs to maintain systolic blood pressure > 85 mm Hg),

(1b2) systemic vascular resistance < 800 dyn•sec•cm^(-5) (if a pulmonary arterial catheter is present),

(1b3) unexplained metabolic acidosis (base deficit > 5 mmol/L)

 

(2) Gastric aspiration: inhalation of gastric contents, witnessed or documented by suctioning of gastric contents from the endotracheal tube

 

(3) Pulmonary contusion: a localized infiltrate appearing on chest radiography within 6 hours of blunt chest trauma, in association with overlying ecchymoses or rib fractures

 

(4) Multiple transfusion: infusion of at least 10 units of whole blood or packed red blood cells within a 12 hour period

 

(5) Multiple fractures: fractures of 2 or more major long bones, an unstable pelvic fracture, or a fracture of a major long bone plus a major pelvic fracture

 

(6) Pneumonia: presence of an infiltrate on chest radiography, plus any 3 of the following 4 factors:

(6a) purulent endotracheal aspirate,

(6b) known pathogens on Gram stain or culture of sputum or blood,

(6c) temperature < 36°C or > 38.5°C,

(6d) white blood cell count > 12,000 per µL or < 3,500 per µL or > 20% immature forms

 

(7) Inhalation injury: hypoxemia within 3 days of smoke inhalation or inhalation of a chemical lung irritant

 

(8) Burn: involvement of > 25% of body surface area in a second and/or third degree burn

 

(9) Acute pancreatitis: severe abdominal pain, nausea and vomiting with a serum amylase level > 3 times the local upper limit of normal

 

(10) Drug overdose

 

(11) Shock: systemic arterial hypotension lasting 2 hours or more (systolic blood pressure < 85 mm Hg, or > 40 mm Hg below the base line value, or need for inotropic drugs to maintain systolic blood pressure > 85 mm Hg)