ARDS Flashcards
What is the difference between cardiogenic and non-cardiogenic pulmonary edema?
Cardiogenic is when there’s increased pressure in capillaries causing high hydrostatic pressure whereas non-cardiogenic (non-hydrostatic) is when there is inflammation causing leaky capillaries so proteins move to the interstitium and there is high oncotic pressure in interstitium
What is the optimal treatment approach for cardiogenic pulmonary edema?
propped upright for cardiogenic pulmonary edema. It puts pressure on the heart
What is ARDS?
Acute respiratory distress syndrome
- a disease of lung inflammation, which leads to lung injury
- non-cardiogenic pulmonary edema, which reduces lung compliance (stiff lungs) since the fluid moving into the alveoli is diluting the surfactant causing the alveoli to collapse.
- Stiff lungs can lead to hypoxemia and respiratory failure
Explain how ARDS can lead to infection?
increases vessel permeability in response to inflammatory process > protein leakage out of the vessel
- increase oncotic pressure shift to drive fluid into the interstitium
Big inflammatory reaction, endothelium (cell membrane), damaged and fluid is leaking out
Fibrin (clotting factor) > thickening of Hyaline membrane > long term lung tissue stiffens up due to remodeling of the tissue (due to inflammatory process)
What is the name of the best definition for ARDS diagnosis?
A) ARDS criteria
B) Starling
C) Berlin
Berlin definition
Why can’t ARDS be treated by increasing FiO2?
You can increase FIO2 a lot and this won’t make a big difference to PAO2 in the blood > lungs get stiff for a variety of reasons
Typically ventilation occurs via positive pressure
- Can lead to pneumothorax and subcutaneous emphysema
- Ventilation becomes very difficult, you can’t just push a larger amount of air in the lungs > alveoli/lungs will be ripped apart since the lungs are very stiff from the inflammation
