ARDS Flashcards
2 main steps in ARDS
- initial insult
2. alveoli fill with fluid
cause of alveoli fluid filling
NOT cardiogenic - due to capillary permiability
3 pathology phases of ARDS
- exudative - inflammation and edema
- proliferative phase -
- fibrosis
what does endotoxin do in
release of tumor necrosis factor and interleukins + cytokines
what goes to lung in ARDS
neutrophils - increase cap. permiability
3 things that happen with fluid in alveoli
- decr. vent > V/Q mismatch
- shunt
- maintained perfusion bc cytokines cause vasodilation
4 ways to treat
- oxygenate - but not over!
- treat primary cause
- vent if required
- use low tidal volumes (pemissive hypercapnea)
5 ways to support in ARDS
- IV fluids
- BP support
- antibiotics
- nutrition
- care of endotracheal tube
keys to fluids in ARDS
balance is keys - don’t dry out too much
what lung volumes DON’t go down with age
RV
what does lung aging resemble
pseudo-emphysema - less elastic as age
what happens to vent as age (2)
- response to hypercapnea blunted
2. blunted perception of dyspnea
what happens to perfusion as age
more constricted
what happens to A-a gradient as age and why
increases due to thicker alveoli and loss of surface area
what happens to chest wall as age
no real evidence of change in compliance without disease
