How does acute respiratory distress syndrome (ARDS) cause hypoxemia?

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

ARDS causes a marked increase in intrapulmonary shunting, leading to severe hypoxemia. Although a high FiO2 is required to maintain adequate tissue oxygenation and life, additional measures, like lung recruitment with PEEP, are often required. Theoretically, high FiO2 levels may cause DAD via oxygen free radical and related oxidative stresses, collectively called oxygen toxicity. Generally, oxygen concentrations higher than 65% for prolonged periods (days) can result in DAD, hyaline membrane formation, and, eventually, fibrosis.


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