ARDS Flashcards
ARDS is…
- sudden and life threatening
- decline in gas exchange
- failure to provide oxygenation
what are the parameters of ARDS
pH of < 7.35
PaO250 ((hypercapnea)
acute vs chronic
what are the 3 main reasons for ARDS
failure to ventilate
failure to oxygenate
failure to maintain airway
name some reasons for failure to ventilate
neuro: can be r/t to mental status, SC injury
muscular: IC muscles
inability to breathe in
guillian barre, myasthenia gravis
chest trauma
name some reasons for failure to oxygenate
diffuison abnormalities
dead space
shunting
alveoli functioning
name some reasons for failure to maintain airway
chest trauma hemothorax barrel chest positioning diaphragm compression mass
Acute Respiratory Failure can be the result of main reasons
Lung Failure(type i)-gas exchange failure by low O2 levels (hypoxemia) Pump Failure(type II) - ventillatory failure by hypercapnea (lack of perfusion)
early signs of acute respiratory failure
restlessness fatigue h/a dyspnea tachycardia hypertension hypoxemia
progressive signs of acute respiratory failure
confusion lethargy tachycardia tachypnea central cyanosis diaphoresis respiratory arrest
why would you see confusion in a progressive sign of ARDS
brain is hypoxic and hypercapneic
how do you manage ARDS
correct underlying cause restore gas exchange in the lung intubation/mechanical ventilation abg SaO2 VS ICU Care
what is the most intense intervention you can do for a pt w/ ARDS?
proning
what is the pharmaceutical therapies that are executed for ARDS
- lasix- shifts fluid from dead space to system for renal system to excrete
- abx for infec
- nitric oxide- inhaled vasodilator
def ARDS
a severe form of acute lung injury that results from:
- severe inflammatory process
- sudden and progressive pulmonary edema
what will the clinician find on the CXR with ARDS?
bilateral infiltrates and consolidation
will ARDS respond to oxygen- with or without PEEP?
no
what other findings will the clinician find with ARDS
reduced lung compliance
death from MODS w/ sepsis
what is a healthy persons natural PEEP?
3
if on a vent, what is the lowest PEEP setting?
5
If on a vent, what is a comfortable high PEEP setting?
15
If on a vent, what is the absolute high PEEP setting?
20
Direct factors a/w the dev of ARDS
PNA aspirations of gastric contents pulmonary contusion near drowning toxic inhalation injury
indirect factors a/w with the dev of ARDS
severe trauma multiple bone fracs flail chest head trauma burns multiple transfusions drug overdose pancreatitis post cardiopulm bypass
ARDS inflammation triggers the release of what
cellular and chemical mediators
