• Arch Intern Med · Nov 1981

    Case Reports

    Diagnosis of adult respiratory distress syndrome associated with underlying severe emphysema.

    • J E Heffner, G W Silvers, and T L Petty.
    • Arch Intern Med. 1981 Nov 1; 141 (12): 1684-5.

    AbstractAdult respiratory distress syndrome (ARDS) notably produces bilateral homogeneous alveolar infiltrates and decreased lung compliance. We encountered a patient whose severe underlying emphysema altered these distinctive clinical features. The chest roentgenogram showed bilateral infiltrates containing multiple radiolucencies that simulated a cavitary process. Also, lung-chest wall compliances measured during mechanical ventilation were higher than usually observed in patients with ARDS. We suggest that the pathologic features of the emphysematous lung with multiple blebs and decreased elastic recoil properties impart these unique findings. When ARDS develops in a patient with severe underlying emphysema, an atypical presentation may produce a confusing clinical picture.

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