What is the cause of bilateral posterior lung infiltrates after cardiopulmonary resuscitation (CPR) and ventricular fibrillation (V Fib) arrest?

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Last updated: May 26, 2025View editorial policy

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Differential Diagnosis for Bilateral Posterior Lung Infiltrates after CPR and V Fib Arrest

  • Single Most Likely Diagnosis
    • Pulmonary Edema: This is the most likely diagnosis due to the association with CPR and V Fib arrest, which can lead to increased pulmonary vascular permeability and fluid accumulation in the lungs.
  • Other Likely Diagnoses
    • Aspiration Pneumonia: During CPR, there is a risk of aspiration, especially if the airway is not properly protected, leading to inhalation of gastric contents and subsequent pneumonia.
    • Acute Respiratory Distress Syndrome (ARDS): The combination of CPR, V Fib arrest, and potential lung injury can trigger ARDS, characterized by non-cardiogenic pulmonary edema and hypoxemia.
    • Pneumonia (community-acquired or hospital-acquired): The patient may have had an underlying infection that was exacerbated by the cardiac arrest and CPR.
  • Do Not Miss Diagnoses
    • Pulmonary Embolism: Although less likely, a pulmonary embolism could present with similar radiographic findings and would be catastrophic if missed.
    • Sepsis: Sepsis can cause bilateral lung infiltrates and is a life-threatening condition that requires prompt recognition and treatment.
  • Rare Diagnoses
    • Reperfusion Injury: This is a rare condition that can occur after CPR and cardiac arrest, where the restoration of blood flow to the lungs leads to inflammation and tissue damage.
    • Fat Embolism Syndrome: Although rare, fat embolism syndrome can occur after traumatic events, including cardiac arrest, and present with respiratory symptoms and bilateral lung infiltrates.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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