Differentials
Shock
SIGNS / SYMPTOMS
Shock can be clinically indistinguishable from ACS and significant overlap exists, because patients develop ACS from excess fluid resuscitation given to treat hypovolemic or septic shock.
INVESTIGATIONS
Intra-abdominal pressure (IAP) is normal.
Acute tubular necrosis
SIGNS / SYMPTOMS
Acute tubular necrosis is clinically indistinguishable from ACS, although may have a history of exposure to nephrotoxic agents.
This condition can also occur as a complication of ACS.
INVESTIGATIONS
The IAP is normal.
Urinalysis may show granular casts.
Renal biopsy shows characteristic features.
Acute renal failure
SIGNS / SYMPTOMS
Renal failure is clinically indistinguishable from ACS.
The condition presents with oliguria in many of the same patient populations that are at increased risk for ACS.
It can also occur as a complication of ACS.
INVESTIGATIONS
The IAP is normal.
Renal ultrasound shows dilated renal calyces (suggesting obstruction) or reduced corticomedullary differentiation.
Renal biopsy reveals intrarenal causes.
Adult respiratory distress syndrome
SIGNS / SYMPTOMS
Patients have cough with expectoration of frothy pulmonary edema.
Basilar or diffuse rales are present on chest auscultation.
Patients generally require higher levels of oxygen and/or PEEP to maintain oxygen saturation >90% than patients with ACS.
INVESTIGATIONS
IAP is normal or mildly elevated (due to pressure transmission from torso to abdomen).
Chest radiograph shows contusion and new bilateral interstitial infiltrates suggestive of pulmonary edema.
Use of this content is subject to our disclaimer