ARF/ARDS Flashcards
Diagnostic criteria for ARDS
- Acute onset on SEVERE noncardiogenic pulm. edema within 1 week of initial lung injury (drowning, gas exposure, PNA/flu, COVID, aspiration)
- Bilateral pulmonary opacities not attributed to other causes
- Altered PaO2/FiO2 ratio
PaO2:FiO2 ratio
Normal: 300-500 mmHg
Mild: 200-300
Moderate: 100-200
Severe: less than 100
S/S Respiratory Failure
-Sudden decrease PaO2 or rapid increase PaCO2
-Early signs hypoxemia/hypercapnia
-Dyspnea
-tachypnea
-prolonged expiration
-nasal flaring
-intercostal muscle retraction
-use of accessory muscles
-decreased SpO2
-tachycardia
hypertension (initially due to compensation), dysrhythmias & hypotension (late)
Pa02:Fi02 ratio Mild
Mild: 200-300
Pa02:Fi02 ratio Moderate
Moderate: 100-200
Pa02:Fi02 ratio Severe
Severe: less than 100
Increases WOB
ET tube/Intubation
*Can cause respiratory failure
Pa02 life threatening value
<40
Pa02 cut off value
<60
S/S of Hypoxia Integumentary system:
-cool, pale, or blue
S/S of Hypoxia Respiratory system:
-SOB, Increased RR
Late signs: Slow RR is a bad sign!
S/S of Hypoxia Cardiovascular system:
-initially increase in HR/BP (its an H!)
Late signs: dysrhythmia, angina, hypotension
S/S of Hypoxia Central nervous system:
-anxiety, restlessness, confusion
Late signs: lethargy, possible coma
Treatment of ARDS
-Fluid and electrolyte balance
CMP daily, I&O hourly, OU hourly – keep “dry” – avoid aggressive fluid resuscitation
-Adequate nutrition
EN/TPN within 48 hours
-Pharmacologic intervention - mostly supportive/adjunct
Pain/sedation/NMB, anti-infectives, bronchodilators/mucolytics, synthetic surfactant
-Psychosocial support
Adequate sleep and rest, provider comfort and education to family, Chaplin and social services
