ARDS , hypoxia

Patients with progressive hypoxia leading to ARDS require mechanical ventilation. Critically ill patients may require sedation when high ventilator settings are used or when patients fight the ventilator. Mechanically ventilated patients should receive sedation by a protocol that includes a daily interruption or lightening of a sedative infusion until the patient is awake.24 The utilization of sedation protocols decreases the duration of mechanical ventilation, length of hospitalization, and tracheostomy rates. 

Transfusion-related acute lung injury is an infrequent but life-threatening complication, clinically indistinguishable from adult respiratory distress syndrome (ARDS). It can occur after the administration of whole blood, erythrocytes, fresh frozen plasma, or cryoprecipitate, all of which contain variable amounts of plasma. In transfusion-related acute lung injury the symptoms of ARDS (dyspnea, pulmonary edema, severe hypoxia, fever, and hypotension) occur within 1-6 hours from the start of transfusion and usually subside within 1-4 days (44). These symptoms can vary from mild to severe and they lead to death in 5-10% of cases. The reaction may be more frequent than reported because confounding factors can mask the symptoms (45). 

ARDS and hypoxia are common in septic patients, even in septic patients without pulmonary infection. Oxygen therapy is indicated to... 

---