Adult Critical Care Specialty (ACCS) Practice Exam

A patient exhibits hypoxemia and tachypnea after surgery. What phase of ARDS are they likely in?

1. Proliferative

2. Exudative

3. Fibrotic

4. Chronic

The correct answer is: Exudative

In the context of Acute Respiratory Distress Syndrome (ARDS), the patient exhibiting hypoxemia and tachypnea after surgery is likely in the exudative phase. This early phase, which occurs within the first week after an insult such as surgery, is characterized by the onset of inflammation in the lungs, leading to increased permeability of the alveolar-capillary membrane. This increased permeability causes fluid accumulation in the alveoli, resulting in hypoxemia due to impaired gas exchange. Tachypnea is a common respiratory response to hypoxemia, as the body attempts to compensate for the decreased oxygen levels by increasing the rate of breathing. The exudative phase also features the development of pulmonary edema and the presence of inflammatory cells in the alveoli, which contribute to the clinical symptoms observed in the patient. The subsequent phases of ARDS, such as the proliferative phase, involve the formation of granulation tissue and resolution of edema, while the fibrotic phase indicates long-term structural changes in the lungs, often leading to chronic respiratory issues. Meanwhile, chronic ARDS would denote a prolonged state of respiratory distress with established fibrosis and persistent symptoms, which are not consistent with this early postoperative scenario. Thus, the features of hypoxemia and tach