Miscellaneous Flashcards
What is acute respiratory distress syndrome (ARDS)?
Increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli, i.e. non-cardiogenic pulmonary oedema
What are the causes of ARDS?
Infection
- Sepsis, pneumonia
Massive blood transfusion
Trauma
Smoke inhalation
Acute pancreatitis
Cardio-pulmonary bypass
What is the criteria for ARDS?
Acute onset, within 1 week of a known risk factor
Pulmonary oedema
- Bilateral infiltrates on chest x-ray not fully explained by effusions, lobar/lung collapse or nodules
Non-cardiogenic
pO2/FiO2 < 40kPa (200 mmHg)
How is ARDS managed?
Due to the severity of the condition patients are generally managed in ITU
Oxygenation/ventilation to treat the hypoxaemia
General organ support, vasopressors as needed
Treatment of the underlying cause, such as antibiotics for sepsis
What is bronchiectasis?
Describes a permanent dilatation of the airways secondary to chronic infection or inflammation
What are the causes of bronchiectasis?
Post infection
- TB
- Pneumonia
- Pertussis
CF
Bronchial obstruction
- Lung cancer
- Foreign body
Immune deficiency
- Hypogammaglobulinaemia
Ciliary dyskinetic syndromes
- Kartagener’s syndrome
- Young’s syndrome
Allergic Bronchopulmonary Aspergillosis
How is bronchiectasis managed?
Inspiratory muscle training
Postural drainage
Antibiotics for exacerbations and long-term rotating antibiotics in severe cases
Bronchodilators in selected cases
Immunisations
Surgery in selected cases/localised disease
What is the most common organism causing bronchiectasis?
Haemophilus influenzae
What imaging sign is seen in bronchiectasis?
Tramlines
Describe oxygen therapy in any critically ill patient
Initially treated with high flow oxygen (15 litres/min reservoir mask) which is then titrated to achieve target sats
