ARDS Flashcards
1
Q
- Pulmonary edema caused by increased pulmonary capillary permeability
- Severe lung injury with respiratory distresspossible respiratory failure
- Criteria for diagnosis is within 7 days of trigger
- May occur within 2 hours of a trigger, often 12-48 hours
- Bilateral pulmonary opacities—*within the alveoli
- Noncardiogenic
- Impaired gas exchange
- PaO2/FiO2<300mm Hg, with PEEP >/= 5cm H2O
- 3 inclusion and 1 exclusion criteria
- Not a specific disease, clinical syndrome that can result from a variety of disease
states—we don’t know how to specifically prevent it
A
ARDS
2
Q
ARDS risk factors
A
sepsis**
3
Q
Severity of ARDS is based on the level of oxygenation impairment
A
- Mild= PaO2/FIO2 ratio between 200 and 300mm Hg
- Moderate=PaO2/FIO2 ratio between 100 and 200mm Hg
- Severe=PaO2/FIO2 ratio less than 100mm Hg
4
Q
steps of ARDS
A
Inflammation–> cytokines–> damage to pulmonary capillary endothelial
cells and alveolar epithelial cells–> increased vascular
permeability–> decreased production and activity of surfactant –> interstitial and alveolar edema –> alveolar collapse –> hypoxemia
5
Q
- Profound dyspnea, cyanosis, tachypnea, intercostal retractions,
crackles - CXR—diffuse patchy infiltrates that proceed rapidly and become
confluent - Air bronchograms
- Heart size normal
- Marked hypoxemia that is refractory to oxygen supplementation
- Multi-organ system failure is common
- Try to r/o something treatable
- PNA, autoimmune problem, alveolar hemorrhage, acute heart problem
A
ARDS symptoms
6
Q
characteristic of ARDS
A
Air bronchogram—air-filled bronchi surrounded by alveoli filled with fluid, pus or other material. It is highly sensitive and specific for the presence of lung consolidation.
7
Q
ARDS treatment
A
- Usually requires mechanical ventilation with PEEP
- Lowest levels of PEEP and O2 required
- Prone positioning
- Central venous catheter
- Fluid management
- ECMO—for very severe cases
8
Q
Mortality with ARDS usually associated with
A
multiple organ failure of sepsis
