ARDS Flashcards
respiratory failure definition
failure of lungs to provide ventilation and/or oxygenation for the blood
What is hypoxemia
PaO2 < 60
What is hypercapnia/hypercarbia
PaCO2 > 45
Early sign on ARDS
refractory hypoxemia
ARDS patho
alveolar damage –> sudden pulmonary edema –> injury to alveolar-capillary membrane (O2 available, but not decreased gas exchange) –> eventually leads to ineffective tissue perfusion
What is refractory hypoxemia
O2 supplementation is occurring, but the body is unresponsive
ARDS early s/s-5
- restlessness
- change in LOC –> confusion
- hypotension
- extreme fatigue
- dyspnea
early ARDS blood gasses
respiratory alkalosis due to increased O2 demand….if sepsis is the cause for the ARDS –> metabolic acidosis
late ARDS blood gasses
respiratory acidosis due to hypoventilation from patient getting tired
ARDS severity criteria-3
- onset within 7 days of injury
- bilateral opacities not explained by effusion, lung collapse, or nodules
- echo rule out heart origin
ARDS severity equation
PaO2 divided by FiO2 (percentage)
ARDS severity equation answer scale
200-300 –> mild
100-199 –> moderate
> 100 –> severe
Causes of ARDS –> direct injury to lungs (5)
- PNA
- toxic inhalation (cocaine, smoke, high concentration of O2)
- gastric aspiration
- near drowning
- lung contusion
Causes of ARDS –> indirect injury to lungs (8)
- SEPSIS
- burn injury
- pregnancy
- trauma
- transfusions
- pancreatitis
- drug effect
- sickle cell crisis
Number one cause of ARDS
Sepsis
Sepsis wheel –> 10 components
- increased HR
- increased RR
- Increased temp
- decreased BP
- decreased SaO2
- decreased output
- increased WBC
- increased neutrophils
- decreased LOC
- increased blood glucose
ARDS collaborative management-12
- supplemental O2
- mechanical ventilation
- proning
- treat underlying cause
- steroids
- nutrition
- fluids
- hemodynamic management
- sedation
- diuretics
- inotropic agents
- inhaled vasodilator
example of inotropic agents (vasopressors)
dobutamine, dopamine
example of inhaled vasodilator
epoprostenol.
benefits of proning in ARDS-6
- improved oxygenation
- allows for recruitment of alveoli
- more effective secretion drainage
- increased CO
- increased FRC
- improved diaphragmatic excursion
prone risks for COVID
patients that were prone are seeing permanent nerve damage
