ch 27 ARDS Flashcards
what is the most severe ARDS
pulmonary edema
what is the mortality of pulmonary edema
40-90%
what type of respiratory failure occurs with pulmonary edema
acute hypoxic respiratory failure
what is the cause of ARDS
increased capillary permeability, fluid leak, inflammation mediators
what is ARDS also called
acute lung injury
what are primary risk factors for ARDS
toxic inhalation near drowning lung contusion gastric aspiration pneumonia
what are secondary risk factors for ARDS
burn injuries sepsis pancreatitis shock prolonged systemic hypotension multiple blood transfusions drug overdose fulminant hepatic failure multiple trauma sickle cell crisis
other risk factors for ARDS
prolonged cardiopulmonary bypass fat emboli immunologic reactions (goodpastures syndrome) increased ICP CNS disorders pulmonary ischemia intravascular coagulation radiation-induced lung injury drug overdose
how long is the exudative phase
1-3 days
how is the alveolus damaged
destruction of type 1 pneumocytes
how is microvascular injuries happen
destruction of capillaries
where is there an influx of inflammatory fluids
interstitial space and alveoli
what membrane forms
hyaline membrane
how does the patient present with ARDS
severe dyspnea, tachypnea, refractory hypoxemia
how long is the fibroproliferative phase
3-7 days
when does the fibroproliferative phase begin after
inflammatory injury is controlled
during the fibroproliferative phase hyperplasia (increase of cells) which cells
type 2 pneumocytes
fibroblasts (intersitial alveolar fibrosis)
what is SOAP
getting objective information
on auscultation what is heard
crackles
what is seen on xray
bilateral fluffy inflitrations
abg’s
ph 7.51
paco2 29
hco3 22
pao2 52
what would you see on a hb curve
acute alveolar hyperventilation with moderate hypoxemia
what are the pulmonary mechanics
all lung volumes decreased
resistance is increased
compliance is decreased
WOB increased
