Ddx: 1. Heart Failure 2. PE 3. Aspiration Pneumonia 4. COPD with acute exacerbation 5. Kidney or Liver Failure 6. MI 7. Arrythmia

Problem List: Shortness of Breath Increased Fatigue Paroxysmal Nocturnal Dyspnea Controlled HTN, Diabetes Clear, White or Blood Streaked Sputum Hyperlipidemia Smoker B/L Crackles Tachycardia Bipedal Edema

1. Pplateau= Lung Compliance, the higher the pressure, the lower the compliance. The Plateau Pressure is an estimate of LUNG COMPLIANCE. As you give more volume to the lungs you can cause overdistension of the lungs. That can create more alveolar damage; It is elevated because the part of the lung that is being ventilated is minimal (only the undamaged part of the lung; so you are workign wiht lower lung volume for ventilation

2. Treatment:

3. Respiraotry Support (PEEP > 5)
4. Treat Inciting Event
5. +/- steroids
6. Prone Positioning More severe Cases:
7. Consider ECMO
8. Pulmonary Vasodialators

1. Patient is presenting with ARDS = Metabolic Acidosis + CXR findings is consistent with diagnosis + inflammatory process (uncontrolled source)

2. Described Previously

Elevated Conjugated Bilirubin, Increased WBC with increased bands = Suspected ascending cholangitis Patient has Hypoxemia that is refractory to O2 treatment which is suggestive of SHUNT PHYSIOLOIGY

Bilteral opacities that are fluffy and "space filling" Patient is Acidosis, Metabolic Acidosis (because CO2 is normal)

CBC w/diff; CMP (BMP), Serum Culture, CXR, ABG (pH | CO2 | O2), RUQ Ultrasound

DDx: Infection -> Sepsis; * Cholescystitis * Hepatitis * Cholangitis * PID * Pancreatitis * Gastritis * Colitis * Non-Cardiogenic Pulmonary Edema (Low Pressure, Inflammatory State)

**Problem List: * RUQ pain (+Murphy's Sign) * Fever + Chills * Nausea * PMH diabetes * Hypotensive * Tachycardia * Increased RR * Hypoxia * B/L Crackles