Pathophysiology:

Etiology:
Predisposing Factor: Injury to the lungs that damages Precipitating Factors:
the vascular endothelium and
• Age (75-84 endothelial lining of the alveoli • Aspiration
years old) • Drugs, Toxins,
and Therapeutic
Agents
• Infections
• Trauma and
Shock

Damage to the Sx: Damage to the epithelial

vascular endothelium • Fever lining of the alveoli

Increases capillary
Platelet aggregation and
permeability
intravascular thrombus
formation

Influx of protein-rich fluid

into the alveolar space Platelets release substances that
attract and activate neutrophils
and complement cascade

A
B
 B

Neutrophils release
inflammatory mediators

Damages the respiratory

membrane and alveolar cells

A Increases capillary permeability

Sx:
• Crackles
Pulmonary edema and Dx Test:
• Dyspnea
hemorrhage • Chest X-Ray

Mgt.:
• Diuretics If unmanaged If managed FAIR PROGNOSIS

Mgt.:
S/Sx: • Use of PEEP
Decrease pulmonary ventilation and • Anxiety
compliance mechanical
• Severe dyspnea ventilator
• Arterial hypoxemia • Supplemental
oxygen
Hyaline membrane forms

Assessment:
C • ABG Analysis
 C

Fibrosis progressively
obliterates the alveoli,
respiratory bronchioles, and
interstitium

Pulmonary
hypertension
Multi-organ failure

Right ventricular failure Respiratory failure

Decrease cardiac
output; decrease
oxygenated blood in
Congestion of the viscera S/Sx: systemic circulation
and peripheral tissues • JVD
• Edema
Decrease in renal
perfusion
Blood backs up in the
hepatic veins Mgt.: S/Sx:
• Diuretics • Sharp decrease
Decrease GFR in u.o.
Liver becomes • Increase BUN
engorged and crea. level
Further decrease in GFR

D E
 D E

Increase pressure within the Accumulation of nitrogenous wastes;

portal vessels alterations in water, electrolyte, and acid-base
balance; inactivation of Vitamin D; disruption
in erythropoietin production
Portal hypertension
Overwhelming infection

Development of high pressure Mgt.:

Force fluid into the abdominal cavity gradient between portal vein and If • Antibioti
inferior vena cava unmanaged cs
S/Sx:
• Abdominal Ascites
pain Venous collaterals develop DEATH
• Anorexia
• Nausea If unmanaged
Abnormal varicoid vessels
Mgt.:
• Diuretics Spontaneous bacterial
peritonitis Prone to rupture and bleeding
• Paracentesi
s
• Sodium Mgt.: Diagnostic
restriction If unmanaged • Antibiotics Bleeding Test:
• Endoscopy
If unmanaged
Sepsis

Hemorrhagic
Shock
DEATH