Which of the following pulmonary diseases most likely complicated his course?
Following a vehicular accident with blood loss leading to prolonged, severe hypotension, a 30-year-old man is intubated and placed on a mechanical ventilator. He has progressively decreasing oxygen saturation despite increasing PEEP and FI02 of 100%. He remains afebrile. He dies 3 days later. At autopsy, the distal lungs show pink hyaline membranes, thickened interstitium, and many macrophages but few neutrophils.
A. Bronchopneumonia B. Chronic bronchitis C. Bronchiectasis D. Viral pneumonia E. Diffuse alveolar damage
Diffuse alveolar damage -(e) correct. diffuse alveolar damage (or ards as it is known clinically) is the final event following lung injury from a variety of serious illnesses or accidents. in this case, it was probably initiated by the hypotension (shock lung) and potentiated by the 100% oxygen.(a) incorrect. a bacterial pneumonia, as a nosocomial infection, is likely to be accompanied by signs of sepsis.(b) incorrect. chronic bronchitis develops and continues over months to years, probably from environmental agents.(c) incorrect. this is a process that takes at least weeks to months and is due to obstruction of airways in one or more parts of lung.(d) incorrect. viral pneumonias are not likely to be acquired in hospital. they are often complicated by bacterial pneumonia.