23 Atelectasis and ARDS

Question 0

Resorptive Atelectasis

Answer 0

Full obstruction of airway
Resorption of gasses through pores of kohn
IPSILATERAL TRACHEAL DEVIATION and Diaphragmatic elevation
Most common cause of fever 24-36 hrs after surgery

Question 1

Atelectasis types

Answer 1

Compression
Resorption
Neonatal
Contraction

Question 2

ARDS

Answer 2

• Noncardiogenic pulmonary edema resulting from acute alveolar or capillary damage
• widespread infiltrates on CXR
• Formation of hyaline membranes
• 60% mortality, those that survive frequently develop progressive interstitial fibrosis

Question 3

ARDS events

Answer 3

Acute lung injury> 
epithelial damage and necrosis> 
chemotaxis>
neutrophil release of cytokines> 
plasma leak into alveolar spaces> 
Hyaline membranes form

Question 4

Histo in recovering ARDS

Answer 4

Hyperplasia of type II pneumocytes

Interstitial inflammation

Question 5

ARDS stages

Answer 5

Exudative 
* 1-2 days edema
* 2-7 days hyaline membrane formation
Proliferative
*8-14 interstital inflammation
* 14 days on fibrosis

Question 6

Neonatal atelectasis

Answer 6

2/2 low surfactant

Surfactant ^ cortisol and thyroxine, Decr by insulin

Question 7

ARDS risk factors

Answer 7

40% gram + sepsis (also diffuse lung infections)
30% Aspiration
10% severe trauma
Pulmonary infections, heroin, smoke inhalation