ARDS Flashcards
What is ARDS?
non-cariogenic pulmonary oedema + diffuse lung inflammation syndrome that often complicates critical illness
What 3 criteria define ARDS?
Acute onset < 1w
Bilateral opacities on CXR
Hypoxaemia (PaO2/FiO2 ratio <300)
If no risk factors for ARDS are present, what should be ruled out?
Acute pulmonary oedema as a result of heart failure
Describe the pathophysiology of ARDS
Severe insults to lungs + other organs leads to release of inflammatory mediators
Lead to increased capillary permeability, pulmonary oedema, impaired gas exchange + reduced lung compliance
List 7 causes of ARDS
SEPSIS
Massive blood transfusion (TRALI)
Trauma/ burns
Inhalation injury
Acute pancreatitis
COVID-19
Cardio-pulmonary bypass
What is the most common cause of ARDS?
Sepsis usually with pulmonary origin e.g. pneumonia
List 4 symptoms of ARDS
Dyspnoea
Fever
Cough
Pleuritic chest pain
List 3 signs of ARDS
Low O2 sats despite supplemental O2
Tachypnoea
Diffuse inspiratory crepitations
List 6 investigations for ARDS
ABG: low PaO2
CXR: bilateral infiltrates
Blood culture: ?infection
Sputum culture: ?infection
Urine culture: ?infection
Amylase + lipase: ?pancreatitis
What is seen on CXR in ARDS?
bilateral alveolar infiltrates + interstitial shadowing
“White out”
Name 2 measurements that indicate ARDS rather than heart failure
Plasma BNP: < 100 pg/mL
Pulmonary artery catheterisation: Normal pulmonary artery occlusion pressure (Pulmonary Capillary Wedge Pressure)
Why may you perform an echocardiogram in ARDS?
Abnormal LV systolic or diastolic function suggests cardiogenic pulmonary oedema rather than ARDS.
Describe the pattern of signs in ARDS
Usually bilateral but may be asymmetrical in early stages
Describe management of ARDS
Admit to ITU
Oxygenation/ ventilation to treat hypoxaemia
Organ support e.g. vasopressors
Tx of underlying cause e.g. abx
Prone positioning + muscle relaxation
