Acute Respiratory Distress Syndrome Flashcards

1
Q

What is Acute Respiratory Distress Syndrome?

A

A syndrome of acute and persistent lung inflammation with increased vascular permeability

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2
Q

What is ARDS characterised by?

A

Acute Onset

Bilateral infiltrates consistent with pulmonary oedema

Hypoxaemia

No clinical evidence of increased left arterial pressure (pulmonary capillary wedge pressure)

ARDS is the severe end of the spectrum of acute long injury

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3
Q

How does ARDS develop?

A

Severe insults to the lungs and other organs leads to the release of inflammatory mediators
These lead to increased capillary permeability, pulmonary oedema, impaired gas exchange and reduced lung compliance

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4
Q

What are the causes of ARDS?

A

Sepsis

Aspiration

Pneumonia

Pancreatitis

Trauma/burns

Transfusion
Transplantation (bone marrow and lung)

Drug overdose/reaction

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5
Q

What are the three pathological stages of ARDS?

A

Exudative

Proliferative

Fibrotic

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6
Q

What is the epidemiology of ARDS?

A

Annual UK incidence: 1/6000

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7
Q

What are the presenting symptoms of ARDS?

A

Rapid deterioration of respiratory function

Dyspnoea

Respiratory Distress

Cough

Symptoms of CAUSE

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8
Q

What are the signs of ARDS on physical examination?

A

Cyanosis

Tachypnoea

Tachycardia

Widespread Inspiratory Crepitations

Hypoxia Refractory to Oxygen Treatment

Signs are usually bilateral but may be asymmetrical in early stages

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9
Q

What are the investigations for ARDS?

A

CXR

Bloods

Echocardiography

Pulmonary Artery Catheterisation

Bronchoscopy

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10
Q

What Chest X-Ray do you do ARDS?

A

Bilateral alveolar infiltrates and interstital shadowing

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11
Q

What bloods do you do ARDS?

A

To figure out the cause

FBC
U&Es

LFTs

ESR/CRP

Amylase

ABG

Blood Culture

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12
Q

Why would you use BNP for ARDS?

A

Plasma BNP < 100 pg/mL could distinguish ARDS from heart failure

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13
Q

Why would you use Echocardiography for ARDS?

A

Check for severe aortic or mitral valve dysfunction

Low left ventricular ejection fractions = haemodynamic oedema rather than ARDS

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14
Q

What would you use Pulmonary Artery Catheterisation for?

A

Check pulmonary capillary wedge pressure (PCWP)

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15
Q

Why would you use Bronchoscopy for ARDS?

A

If the cause can’t be determined from the history

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