ARDS PE FES

Question 1

Def ARDS

Answer 1

Question 2

Risk factors ?
Direct and indirect ?

Answer 2

Question 3

Pathogenesis ?
3 fases?

Answer 3

1.Acute phase
Pulmonary oedema due to damage of alveolar cap barrier
Complex inflammatory exudate
Surfactant dysfunction

2. Fibroproliferative stage
3. Resolution

Question 4

What are the consequences ?

Answer 4

• Diffusion abnormalities and V/Q mismatch – hypoxaemia
• Reduced lung compliance
• Increased dead space ventilation

Question 5

Pathophysiology ?

Answer 5

Question 6

Treatment?

Answer 6

• Mainstay of treatment is supportive care
• Treat underlying cause
• Positive pressure ventilation with supplemental O2 and PEEP
• Fluid management
• Slight negative balance

Question 7

Ventilation strategy?

Answer 7

Avoid Hyperoxia
* FiO2
should be dropped below 50% within 24 hours where possible
* Accept saturations > 88%
* Sats > 94% ideally in cardiac and TBI patients
* 100% IS NOT THE AIM

Permisive hypercapnia
* PCO2 permitted to rise rather than increase ventilator settings
* Limits volutrauma / barotrauma / atelectrauma
* Elevated CO2 may inhibit inflammation
* Precautions:
* Superimposed metabolic acidosis
* Cerebral oedema
* Hypovolaemia
* Beta blockade
* pH > 7.25 / PaCO2 < 60 mm Hg

Question 8

PE- Def?
Etiology ?

Answer 8

Question 9

Pathophysiology ?

Answer 9

Question 10

Diagnosis

Answer 10

Question 11

Treatment
Duration of treatment?

Answer 11

Question 12

FES
Pathophysiology?

Answer 12

Question 13

Causes?
Risk factors in trauma

Answer 13

Risk factors in blunt trauma
* Age < 30 years
* Femur fracture
* Multiple long bone fractures

Question 14

Diagnostic criteria ?

Answer 14

Question 15

Mangement

Answer 15

Supportive