Which of the following is NOT typically associated with acute respiratory distress syndrome (ARDS)?

Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition characterized by widespread inflammation in the lungs, leading to several physiological changes. The condition is primarily associated with symptoms and complications that profoundly affect respiratory function.

Hypoxemia is a hallmark of ARDS, as the condition results in impaired gas exchange due to fluid accumulation in the alveoli, making it difficult for oxygen to pass into the bloodstream. Pulmonary edema, which refers to excess fluid in the lungs, is also directly associated with ARDS. This edema is primarily attributed to increased permeability of the alveolar-capillary membrane, which leads to leakage of fluid into the lung interstitium and alveoli. Increased alveolar permeability is another key feature of ARDS, as it allows proteins and fluid to enter the lung spaces, exacerbating hypoxemia and respiratory failure.

In contrast, systemic congestion, while it can occur in various other conditions involving heart failure or fluid overload, is not specifically associated with ARDS itself. ARDS predominantly affects the lungs and is characterized by localized pulmonary changes rather than systemic vascular congestion. Therefore, systemic congestion is not a typical feature of ARDS, making it the correct choice for the question asking which is NOT typically associated with the syndrome.