Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH Für Intensivmedizin Spécialiste FMH En Médecine Intensive Exam

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A 58-year-old intubated woman with severe bilateral pulmonary infiltrates and refractory hypoxemia undergoes transpulmonary thermodilution monitoring (PiCCO). The device reports an Extravascular Lung Water Index (EVLWI) of 16 mL/kg (normal 3-7 mL/kg), a Pulmonary Vascular Permeability Index (PVPI) of 3.8 (normal 1.0-3.0), and a Global End-Diastolic Volume Index (GEDVI) of 680 mL/m² (normal 680-800 mL/m²). How should these hemodynamic findings be interpreted?

Cardiogenic pulmonary edema due to left ventricular volume overload and elevated hydrostatic pressures Non-cardiogenic pulmonary edema characteristic of Acute Respiratory Distress Syndrome (ARDS) with increased capillary permeability Severe intravascular hypovolemia without true pulmonary parenchymal fluid accumulation Isolated right ventricular failure with pulmonary arterial hypertension and normal alveolar permeability

Correct Answer:

Non-cardiogenic pulmonary edema characteristic of Acute Respiratory Distress Syndrome (ARDS) with increased capillary permeability

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