Which of the following statements are true regarding the diagnosis of Acute Respiratory Distress Syndrome (ARDS)? Select All that Apply.

Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition characterized by diffuse alveolar damage, increased pulmonary capillary permeability, and non-cardiogenic pulmonary edema. It results in severe hypoxemia that is often refractory to oxygen therapy. Diagnosis is based on clinical presentation, arterial blood gas findings, and characteristic imaging showing bilateral lung involvement. Identifying the underlying cause, such as infection or systemic inflammation, is essential for targeted management. Rationale: A. Common causes of ARDS include pneumonia and sepsis, which are among the most frequent triggers of the inflammatory cascade leading to alveolar damage. These conditions cause widespread cytokine release, increasing capillary permeability and resulting in fluid accumulation in the alveoli. Other causes include aspiration, trauma, and pancreatitis. B. Blood gas analysis is essential to identifying the severity of ARDS because it provides information on oxygenation status and gas exchange efficiency. A hallmark finding is severe hypoxemia with a reduced PaO₂/FiO₂ ratio. ABGs help classify ARDS severity and guide ventilatory management strategies. C. Clients with ARDS commonly present with decreased oxygen saturation that does NOT significantly improve with supplemental oxygen. This refractory hypoxemia occurs due to intrapulmonary shunting and alveolar collapse. The statement is incorrect because oxygen therapy alone is often insufficient to correct the underlying gas exchange defect. D. Imaging must indicate bilateral lung infiltrates to support the diagnosis of ARDS. Chest X-rays or CT scans typically show diffuse, bilateral opacities consistent with pulmonary edema not explained by cardiac failure. This radiographic finding is a key diagnostic criterion for ARDS. E. Elevated BNP is not permissible or diagnostic for ARDS. Brain natriuretic peptide (BNP) is associated with heart failure and helps differentiate cardiogenic pulmonary edema from ARDS. In ARDS, BNP is typically normal or not significantly elevated because the condition is non-cardiogenic in origin.