A 38-year-old man is admitted to the hospital 12 hours after the onset of severe abdominal pain and vomiting. He has a history of alcohol use disorder, with several previous admissions for intoxication and acute pancreatitis. Ten hours after admission, he has worsening dyspnea. His temperature is 38.3°C (100.9°F), pulse is 120/min, respirations are 30/min, and blood pressure is 100/60 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 85%. The patient is intubated and mechanically ventilated. Physical examination shows diffuse lung crackles, marked epigastric tenderness. Chest x-ray reveals new bilateral opacities. Which of the following parameters is most likely to be normal in this patient?

Question

A 38-year-old man is admitted to the hospital 12 hours after the onset of severe abdominal pain and vomiting. He has a history of alcohol use disorder, with several previous admissions for intoxication and acute pancreatitis. Ten hours after admission, he has worsening dyspnea. His temperature is 38.3°C (100.9°F), pulse is 120/min, respirations are 30/min, and blood pressure is 100/60 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 85%. The patient is intubated and mechanically ventilated. Physical examination shows diffuse lung crackles, marked epigastric tenderness. Chest x-ray reveals new bilateral opacities.  Which of the following parameters is most likely to be normal in this patient?

Quizplus · Accepted Answer

Eductional Objective: Acute respiratory distress syndrome is characterized by hypoxia and bilateral pulmonary infiltrates and is associated with pneumonia, sepsis, trauma, and pancreatitis.  The associated pulmonary edema is noncardiogenic in nature, so the pulmonary capillary wedge pressure will be within the normal range (6-12 mm Hg).

A 38-Year-Old Man Is Admitted to the Hospital 12 Hours