Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by:
A) Hyperventilation
B) Excessive surfactant
C) Hyperinflated alveolar sacs
D) Ventilation–perfusion mismatch
Ans: D
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Despite the delivery of high levels of oxygen using high-pressure mechanical ventilatory support and positive end-expiratory pressure, many persons with ALI/ARDS remain hypoxic, often with a fatal outcome. Arterial blood gas analysis establishes the presence of profound hypoxemia with hypercapnia, resulting from impaired matching of ventilation and perfusion and from the greatly reduced diffusion of blood gases across the thickened alveolar membranes. Abnormalities in the production, composition, and function of surfactant may contribute to alveolar collapse and gas exchange abnormalities.
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