ARDS, Muthiah Flashcards
Four Key Findings in ARDS
1) Diffuse Alveolar Damage
2) Increased Microvascular Permeability
3) Non-cardiogenic Pulmonary Edema
4) Acute Refractory Hypoxemia
ARDS Diagnostic Criteria
1) Acute onset of respiratory failure
2) Bilateral Infiltrate on CXR
3) PCWP (pulmonary capillary wedge pressure)<200 (major ARDS)
Mechanism of ARDS
1) Inflammatory mediators cause endothelial and epithelial damage
2) Increased permeability of capillary membranes
3) Fluid extravasation/edema of airspaces
4) Dysfunction of Surfactant
ARDS Causes due to Direct Lung Injury
1) Pneumonia
2) Aspiration of Gastric contents
3) Contusion
4) Fat Emboli
5) Near Drowning
6) Inhalation injury
ARDS Causes due to Indirect Lung Injury
1) Sepsis
2) Shock-mediated Hypoperfusion of lung
3) Drug overdose
4) Cardiopulmonary Bypass
5) Acute Pancreatitis
6) Transfusion of Blood Products
4 Stages of ARDS
1) Exudative Phase
2) Proliferative Phase
3) Fibrotic Phase
4) Recovery Phase
4 Factors which increase the risk of mortality of ARDS
1) Sepsis [worst]
2) Chronic liver disease
3) Non-Pulmonary Organ Dysfunction
4) Advanced Age
4 Components of ARDS Lung Injury Scoring System
1) CXR
2) [PaO2/FiO2]
3) PEEP
4) Respiratory Compliance
PEEP
Positive End Expiratory Pressure; opens collapsed alveoli by changing the distribution of water molecules at the alveolar membrane, thus reducing surface tension
Pneumothorax which is secondary to ARDS is caused by:
Pulmonary Interstitial Emphysema
Pneumothorax which is secondary to ARDS usually occurs at what point after the initial ARDS onset?
Two weeks.
Most common etiologic agent of Pneumonia:
Streptococcus Pneumoniae
True or false: Use of a lower tidal volume can reduce ARDS mortality.
TRUE
True or False: Conservative Fluid Management reduces the amount of days that a patient is on a Mechanical Ventilator.
TRUE.
