35 - Restrictive Lung Disorders

Question 1

1) Know the concept of “restrictive lung disorders”

Answer 1

• Restrictive lung disorders are the result of decreased expansion of the lungs due to alterations in lung parenchyma, pleura, chest wall, or neuromuscular function

Question 2

2) Understand from a pathophysiological standpoint the 4 main categories of restrictive lung disorders

Answer 2

• Lung parenchyma disorder: fibrotic interstitial lung disease (diffuse interstitial lung disease, sarcoidosis, hypersensitivity pneumonities), atelectatic disorders (ARDS, IRDS)
• Pleural space disorders: pnemothorax, pleural effusion
• Neuromuscular, chest wall, obesity disorders:
• Infection or inflammation of the lungs: Pneumonia

Question 3

3) Define ARDS

Answer 3

• A severe respiratory distress condition characterized by damage to the alveolar capillary membrane, manifested by noncardiogenic pulmonary edema, respiratory distress, and hypoxemia.
• Diagnosed by decrease in arterial pressure and an inability to use supplemental oxygen therapy

Question 4

4) Know the common conditions that could cause ARDS

Answer 4

• Sepsis, aspiration of gastric acids account for 70% of cases, fat embolism.

Question 5

5) Know the three key pathological features of ARDS

Answer 5

• Non-cardiogenic pulmonary edema associated with leaky pulmonary capillaries
• Atelectasis associated with lack of surfactant
• Fibrosis associated with inflammatory deposition of proteins

Question 6

6) Recognize the defining clinical characteristics of ARDS

Answer 6

• Every spirometry reading and non-spirometry reading diminished
• Significant right to left shunt (V/Q = 0)…region with high and a region with low V/Q
• Hypoxemia, crackles, wheezing, dyspnea, use of accessory muscles, hypercapnia/hypoxemia that doesn’t improve with oxygen therapy