Acute Respiratory Distress Syndrome Flashcards
1
Q
What can cause ARDS/acute lung injury?
A
may be caused by direct lung injury or occur secondary to severe systemic illness
2
Q
What happens as a result of lung damage?
A
Lung damage and release of inflammatory mediators cause increased capillary permeability and non-cardiogenic pulmonary oedema, often accompanied by multi-organ failure
3
Q
What are the main pulmonary causes of ARDS?
A
- Pneumonia
- Gastric aspiration
- Injury
- Vasculitis
- Contusion
4
Q
Other causes of ARDS
A
- Shock
- Septicaemia
- Haemorrhage
- Multiple transfusions
- Disseminated intravascular coagulation (DIC)
- Pancreatitis
- Acute liver failure
- Trauma
- Head injury
- Malaria
- Fat embolism
- Obstetric events (eclampsia, amniotic fluid embolus)
- Drugs/toxins (aspirin, heroin, paraquat)
5
Q
What are the clinical features of ARDS?
A
- Cyanosis
- Tachypnoea
- Tachycardia
- Peripheral vasodilation
- Bilateral fine inspiratory crackles
6
Q
What investigations should be performed if ARDS is suspected?
A
- FBC
- U&E
- LFTs
- Amylase
- Clotting
- CRP
- Blood cultures
- ABG
- CXR – show bilateral pulmonary infiltrates
- Pulmonary artery catheter – to measure pulmonary capillary wedge pressure (PCWP)
7
Q
What is the diagnostic criteria for ARDS?
A
- Acute onset
- CXR = bilateral infiltrates
- PCWP <19mmHg or lack of clinical congestive heart failure
- Refractory hypoxaemia with PaO2:FiO2 <200 for ARDS
* *Others include total thoracic compliance <30mL/cmH2O
