Mod 2-6 ARDS

Question 1

What has been known since WW1 in reference to respiratory failure?

Answer 1

Some patients with non thoracic injuries, severe pancreatitis, massive blood transfusion, sepsis (severe infection) and other conditions develop respiratory distress, diffuse lung infiltrates and respiratory failure hours to days after.

Question 2

What is the term used to describe respiratory failure hours to days after an injury or illness?

Answer 2

Shock lung

Question 3

What is ARDS?

Answer 3

Adult Respiratory Distress Syndrome - Severe, unexpected life-threatening acute respiratory distress in patients with a variety of medical and surgical disorders but no major underlying lung disease.

Question 4

What is the key of ARDS?

Answer 4

That the patient is very ill without any underlying lung disease but develop a form of pulmonary edema.

Question 5

Where does fluid collect in ARDS?

Answer 5

In the airspaces and interstitium.

*Can lead to acute respiratory failure

Question 6

What happens as a result of fluid in the air spaces from ARDS?

Answer 6

Inhibits the ability of surfactant to function properly therefore microatelectasis forms throughout the lungs and air exchange is inhibited.

Question 7

What type of patient does ARDS occur most?

Answer 7

Those with severe pulmonary infection.

Question 8

Other than severe pulmonary infection, what are some other conditions associated with ARDS?

Answer 8

Aspiration or inhalation of toxins and irritants, drug overdose, and those with non thoracic trauma (especially multiple fractures, head injury, lung contusions).
*Regardless of cause there is a complete breakdown in the structure and thus the function of the lung.

Question 9

What type of damage occurs in ARDS?

Answer 9

Diffuse alveolar damage

Question 10

The products created by the inflammatory process allows what?

Answer 10

The alveolus to become permeable so fluid begins to slowly fill and damage the lung parenchyma.

Question 11

There is radiographic evidence of the parenchyma damage in its early stage. T/F?

Answer 11

False

Question 12

What is the mortality rate of ARDS?

Answer 12

40-60%

Question 13

How many stages are in the process of ARDS?

Answer 13

4

Question 14

List the four stages of ARDS.

Answer 14

1) Normal, progression to some dyspnea
2) Respiratory distress, anxiety, cool clammy skin, elevated blood pressure, tachypnea, tachycardia and radiograph will show some linear streakiness as inflammatory exudate begins to fill the interstitial areas of the lungs as well as the alveoli.
3) Appears gravely ill, struggles for breath, decrease in mental capacity.
4) Acute respiratory failure

Question 15

What develops as respiratory distress worsens?

Answer 15

Respiratory acidosis develops

Question 16

What is the visible radiographic difference between pulmonary edema seen in heart failure and pulmonary edema seen with ARDS?

Answer 16

The heart is of normal size with ARDS.

Question 17

Does ARDS effect radiographic technique?

Answer 17

Yes, pulmonary edema associated with ARDS presents a density so it is harder to penetrate. Increase technique.