Acute Respiratory Distress Syndrome - ARDS

Question 1

What is ARDS?

Answer 1

Acute respiratory distress syndrome (ARDS) is an acute condition characterized by bilateral
pulmonary infiltrates and severe hypoxemia in the absence of evidence for cardiogenic
pulmonary edema

Question 2

What are the causes of ARDS?

Answer 2

-Sepsis,
- shock,
- multiple blood transfusions,
- lung contusion,
- aspiration of gastric contents and drug abuse or overdose are common.
- burns,
- pancreatitis,
- smoke inhalation,
- pneumonia and near drowning can cause this condition.
- The inhalation of irritants, chemical warfare agents such as phosgene, chlorine gas can
also cause ARDS.
- Some cases of ARDS are linked to large volumes of fluid used during post-trauma
resuscitation

Question 3

Whats the Pathophysology of the condition?

Answer 3

1- Pulmo or systemic inflammation leads to release of cytokines and other pro inflam molecules.

2. cytokines activate Alveolar macrophages and brings neutrophils to lungs which then leads to release of leukotrienes, oxidants, Platelet activating factor and proteases. these damages the capillary endothelium. increases membrane permiability
3. edema fluid proteins and celluar debris leaks to airspace causing distruption in surfactants–> airspace collapse—> ventilation perfusion mismatch—> pulomonary hypertension.

The acute phase of ADS usually resolves completely. Less commonly, residual pulmonary
fibrosis occurs

Question 4

What are the complaints of the patients?

Answer 4

• development of acute dyspnea and hypoxemia within 12-48 hours of an inciting event.
  With the onset of lung injury, patients initially note dyspnea with exertion.
  This rapidly
  progresses to severe dyspnea at rest, tachypnea, anxiety, agitation, and the need for increasingly high concentrations of inspired oxygen.

Question 5

What can you find in a physical examination?

Answer 5

tachypnea,

• tachycardia.
• The patient may be febrile or hypothermic.
• Cyanosis of the lips and nail beds may occur.
• Examination of the lungs may reveal diffuse bilateral rales.
• State of the patient progressively worsens.
• Severe acute hypoxemic respiratory failure develops.

Question 6

How can you treat ARDS?

Answer 6

-People with ARDS are treated in an intensive care unit. Successful treatment usually
depends on treating the underlying disorder.
-Oxygen therapy, very high doses of inhaled oxygen are required,
-mechanical ventilation must be used.