Adult Critical Care Specialty (ACCS) Practice Exam

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What distinguishes the fibrotic phase of ARDS?

  1. Pulmonary fibrosis and decreased lung capacity

  2. Neutrophil response and significant atelectasis

  3. Acute inflammation with improved oxygenation

  4. Resolution of fluid accumulation in the alveoli

The correct answer is: Pulmonary fibrosis and decreased lung capacity

The fibrotic phase of Acute Respiratory Distress Syndrome (ARDS) is characterized by the development of pulmonary fibrosis and a decrease in lung capacity. During this phase, there is significant remodeling of the lung tissue due to persistent inflammation and scarring, which leads to the alteration of normal lung architecture. As fibrosis progresses, the affected lung areas become less compliant, making it difficult for the lungs to expand fully during inspiration. This results in decreased lung capacity and compromised gas exchange, ultimately affecting oxygenation in the bloodstream. In contrast, the other phases or responses associated with ARDS focus on inflammation, fluid accumulation, or recovery, rather than the specific fibrotic changes and decreased capacity that highlight this distinguishing phase. Understanding the fibrotic phase is critical for managing ARDS as it can impact recovery and long-term respiratory function.