Acute respiratory distress syndrome Flashcards
1
Q
define:
A
Non-cardiogenic pulmonary oedema and diffuse lung inflammation syndrome.
2
Q
Aetiology/risk factors:
A
Direct lung damage or systemic illness –> lung damage –> release of inflammatory mediators –> increased capillary permeability –> pulmonary oedema and decreased surfactant–> reduced gas exchange and compliance
3
Q
What are pulmonary causes of ARDS:
A
Pneumonia Gastric aspiration Smoke inhalation injury vasculitis contusions
4
Q
What are non-pulmonary causes of ARDS:
A
pancreatitis Acute liver failure fat embolism burns drugs/toxins - aspirin and opiates shock septicaemia haemorrhage multiple transfusions DIC head injury malaria obstetric causes e.g. ectopic pregnancy
5
Q
symptoms:
A
SOB
Cough
respiratory distress
acute onset
6
Q
signs:
A
tachypnoea cyanosis tachycardia bilateral widespread fine crackles hypoxia refractory to oxygen treatment bilateral signs but can be unilateral at the start peripheral vasodilation
7
Q
Investigations:
A
Diagnostic criteria:
- pulmonary capillary wedge pressure <19mmHg or no cardiac involvement (done by pulmonary artery catheterisation)
- CXR- bilateral infiltrates + alveolar and intestinal shadowing
- Acute onset
- refractory hypoxemia (resistant to oxygen treatment)
Other:
-Bloods - FBC, U+ Es, amylase, clotting, sputum and blood cultures, CRP/ESR, ABG
Echo to investigate any valvular disease
Bronchoscopy - rule out other causes
