Acute Respiratory Distress Syndrome Flashcards
1
Q
What is another term for ARDS?
A
post-traumatic lung
2
Q
What is the mortality rate of ARDS?
A
40-60%
3
Q
Summarize what happens in ARDS?
A
- severe damage to alveolar and capillary walls
- increased permeability from both inflammation and damage
- alveoli fill with exudate and other materials, which solidify
- gas exchange can’t happen
4
Q
What causes ARDS?
A
- near drowning
- aspiration
- drugs (cocaine, heroin)
- inhaled gases (smoke inhalation, ammonia)
- breathing a high concentration of oxygen
- radiation
- septicemia (bacteria in blood, passes through and damages the lungs)
- fat embolism
- chest trauma
- disseminated intravascular coagulation (liver failure)
- multiple blood transufions
5
Q
What is the pathology of ARDS?
A
- lung trauma causes inflammation and an influx of neutrophils
- the neutrophils release: free radicals, phospholipids, proteases, which cause endothelial and alveolar damage (and increasing the inflammatory response)
- the damage causes NON-PHYSIOLOGIC increase in permeability
- this allows the efflux of proteins, cells, fluid into the interstitial space and alveoli, causing edema
- causes a decrease in compliance and impairs gas exchange
- damage affects cells that make surfactant = surfactant deficiency = atelectasis
- thick protein and cell rich exudate lines the alveoli = no gas exchange
- an impervious, hyaline membrane lines he alveoli
- results in profound hypoxemia
6
Q
What are the manifestations of ARDS?
A
acute onset of respiratory distress:
- dyspnea
- tachypnea
- hypoxemia
- early respiratory alkalosis (hyperventilation causing an increase in CO2 blown off)
- late metabolic acidosis (as a result of anaerobic metabolism)
- diffuse consolidation
7
Q
How is ARDS treated?
A
- early intervention is key
- reverse if you can
- respiratory support (may not help if very advanced)
- recognize, avoid, treat complications
