Acute respiratory distress syndrome (ARDS)

Question 1

What is ARDS?

Answer 1

Non-cardiogenic pulmonary oedema and diffuse lung inflammation, typically secondary to an underlying illness

Question 2

Name 2 causes of ARDS

Answer 2

• Pneumonia (commonest cause)
• Sepsis
• Massive blood transfusion
• Trauma
• Acute pancreatitis
• Aspiration

Question 3

1) How does ARDS often present?
2) Name 2 signs or symptoms that occurs with this presentation

Answer 3

1) Acute onset respiratory failure which fails to improve with supplemental oxygen
2) Dyspnoea, tachypnoea, confusion, and presyncope, bilateral lung crackles
low oxygen saturations

Question 4

What are the 2 key investigations for ARDS?

Answer 4

• Chest x-ray
• Arterial blood gasses

Question 5

Name 2 aspects of the management of ARDS

Answer 5

• Usually managed in ITU
• Oxygenation/ventilation support to treat the hypoxaemia
• General organ support e.g. vasopressors
• Treatment of the underlying cause
• DVT prophylaxis
• Regular repositioning

Question 6

What position can improve symptoms?

Answer 6

Patient lying on their stomachs/face down

Question 7

In order to diagnose ARDS for pulmonary oedema, what cause of pulmonary oedema has to be excluded first?

Answer 7

Cardiac cause

Question 8

Name a feature of the history and investigations of pulmonary oedema that would make a diagnosis of cardiogenic pulmonary oedema more likely than ARDS

Answer 8

• Recent history of MI
• Raised capillary pulmonary wedge pressure

Question 9

Transfusion related lung injury is the specific name given to what?

Answer 9

ARDS that happens within 6 hrs of a blood transfusion