Hypoxemic Respiratory Failure

Question 1

Berlin Definition of ARDS

Answer 1

Timing - within 1 week of clinical insult or new/worsening respiratory sx

Imaging - bilateral opacities not fully explained by effusion, lobar collapse, or nodules

Edema - Not fully explained by CHF or fluid overload

Question 2

Mild, Moderate, and Severe ARDS ranges

Answer 2

Mild = 200 - 300

Moderate = 100 - 200

Severe = < 100

Question 3

Amount of peep in high flow O2

Answer 3

1 cm H20 / 10 LPM flow

Question 4

Volutrauma defintion

Answer 4

Overdistention of alveoli

Question 5

Atelectrauma definition

Answer 5

Shear stress of cyclic collapse-recruitment of alveoli

Question 6

Biotrauma definition

Answer 6

Lung elaboration and systemic release of inflammatory cells and mediators

Question 7

Recruitment maneuver examples

Answer 7

40 cm H2O for 40 seconds

Ramp up, ramp down pressure method

Question 8

ARDSNet Conservative fluid management strategy

Answer 8

Question 9

When to consider albumin with lasix

Answer 9

When serum protein < 5

Question 10

Dose at which nitric oxide in ARDS poses risk of methemoglobinemia

Answer 10

Greater than 80 ppm