Which statement about ARDS pathophysiology is accurate?

Which statement about ARDS pathophysiology is accurate?

• A. Lung fluid accumulation in ARDS contributes to hypoxemia.
• B. ARDS leads to increased lung compliance.
• C. Surfactant remains unaffected.
• D. Oxygen therapy alone cures ARDS without ventilation support.

Answer: (A)

In ARDS, injury to the alveolar-capillary membrane makes it highly permeable, so protein-rich fluid leaks into the alveoli and interstitium. That alveolar flooding thickens the gas-exchange barrier and promotes collapse of air sacs, creating regions that are poorly oxygenated and, more importantly, a significant shunt where blood passes through without getting oxygenated. This combination drives hypoxemia that is often refractory to oxygen therapy alone. That’s why the statement about fluid accumulation contributing to hypoxemia is accurate. The other points aren’t correct because ARDS actually reduces, not increases, lung compliance due to stiff, fluid-filled lungs; surfactant function is impaired rather than unaffected, which worsens alveolar collapse; and oxygen therapy by itself does not cure ARDS—ventilation support with strategies like PEEP is typically needed to keep alveoli open and improve oxygenation.

In ARDS, injury to the alveolar-capillary membrane makes it highly permeable, so protein-rich fluid leaks into the alveoli and interstitium. That alveolar flooding thickens the gas-exchange barrier and promotes collapse of air sacs, creating regions that are poorly oxygenated and, more importantly, a significant shunt where blood passes through without getting oxygenated. This combination drives hypoxemia that is often refractory to oxygen therapy alone.

That’s why the statement about fluid accumulation contributing to hypoxemia is accurate. The other points aren’t correct because ARDS actually reduces, not increases, lung compliance due to stiff, fluid-filled lungs; surfactant function is impaired rather than unaffected, which worsens alveolar collapse; and oxygen therapy by itself does not cure ARDS—ventilation support with strategies like PEEP is typically needed to keep alveoli open and improve oxygenation.