Fluid Balance and Renal Function

Acute hypoxemic respiratory failure can be a consequence of alveolar edema accumulation due either to increased pulmonary capillary hydrostatic pressure, as in congestive heart failure, or through increased alveolar capillary permeability, as in the syndrome of acute respiratory distress in adults (ARDS) [1,2]. Increased capillary permeability allows extravasation of plasma constituents into the interstitial space. The interstitium is a compliant compartment normally able to accommodate large amounts of fluid. However, when it is overwhelmed, fluid spills into the alveolar air spaces [3]. Extra vascular lung water must increase by at least 20% before alveolar flooding occurs [4]. The etiology of ARDS remains unknown, but in several large studies sepsis, gastric acid aspiration, trauma and blood product transfusion following trauma accounted for most cases of [5].