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Impaired Gas Exchange related to pulmonary fluid accumulation (e.g., as seen in heart failure or acute respiratory distress syndrome (ARDS), affecting oxygen and carbon dioxide exchange) as evidenced by crackles on auscultation, dyspnea at rest, and hypoxemia on arterial blood gas analysis

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[22] [23] [24] The German Empire also had anti-tobacco sentiment in the early 20th century