ARDS

Question 1

Clinical syndrome of:
severe dyspnea of rapid onset + hypoxemia + diffuse pulmonary infiltrates
leading to respiratory failure

Answer 1

ARDS

Question 2

Causes of Direct Lung Injury

Answer 2

Pneumonia 
Aspiration of gastric contents
Pulmonary contusion
Near-drowning
Toxic inhalation injury

Question 3

Clinical phases of ARDS

Answer 3

Exudative
Proliferative
Fibrotic

Question 4

Duration of ARDS phases

Answer 4

Exudative phase: 1st 7 days
Proliferative: 7-21 days
Fibrotic: 3-4 weeks after the initial pulmonary injury

Question 5

Phase of accumulation of edema fluid rich in protein in the interstitial and alveolar spaces

Answer 5

Exudative phase

• injury of alveolar capillary endothelial cells and type 1 pneumocytes
• CXR: alveolar and interstitial opacities >/= 3/4 of the lung fields

Question 6

Period of liberation from mech vent, shift from neutrophil to lymphocyte-predominant

Answer 6

Proliferative phase

*type II pneumocytes

Question 7

Marker of pulmonary fibrosis

Answer 7

Presence of alveolar type III procollagen peptide

Question 8

Phase requiring long-term mech vent support and/or supplemental O2

Answer 8

Fibrotic phase

Question 9

Consequences of Fibrotic phase

Answer 9

Inc risk for pneumothorax
Inc pulmo dead space
Dec lung compliance

Question 10

Prevention of ARDS with strong clinical evidence

Answer 10

Low Tidal Volume