ARDS Flashcards
what is ARDS
hypoxic respiratory failure caused by intense pulmonary inflammation
primary insult in ARDS
pneumonia, aspiration, near drowning, smoke inhalation
secondary insult in ARDS
sepsis/SIRS, trauma, cardiac arrest, burns
pulmonary artery wedge pressure of ARDS
less than 18
most common causes of ARDS
shock, sepsis and drowning
What happens with increased inflammation in lungs
increased permeability of pulmonary capillaries and alveoli, pulmonary edema, and ultimately pulmonary fibrosis
how can increased pulmonary inflammation lead to pulmonary hypertension
refractory hypoxia causing loss of pulmonary vasomotor tone
3 phases of ARDS
inflammation or exudative 0-7 days
proliferative 7-21 days
fibrotic phase 7-1 days
what happens in first phase of ARDS
inflammation phase, causing pulmonary hypertension
what happens in second phase ARDS
fibroblast proliferation
Ventilatory goals for ARDS
maximize PEEP while minimizing ventilator induced lung injury
medications that may be helpful in ARDS
nitric oxide
corticosteroids
surfactant
indications to intubate
worsening lung disease
hypoxemia despite non invasive delivery of O2
increased WOB, increased dead space, decreased lung compliance
to what level of permissive hypercapnia is allowed to avoid Ventilator induced lung injury
pH 7.2
When is High frequency oscillatory ventilation used
when there needs to be low tidal volume and avoid barotrauma
maintains lung volume at sustained pressure
