Respiratory failure

Question 1

Acute respiratory distress syndrome

Answer 1

Increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli

Mortality around 40%

Question 2

Causes of ARDS

Answer 2

Infection (sepsis, pneumonia)

Massive blood transfusion

Trauma

Smoke inhalation

Acute pancreatitis

Covid-19

Cardio-pulmonary bypass

Question 3

Clinical features of ARDS

Answer 3

Dyspnoea

Elevated resp rate

Bilateral lung crackles

Low oxygen sats

Question 4

Investigations for ARDS

Answer 4

Chest xray

ABG

Question 5

Criteria for diagnosis

Answer 5

Acute onset (within 1 week of a known risk factor)

Pulmonary oedema (bilateral infiltrates on chest xray)

Non-caridogenic

pO2/Fi)2 <40kPa

Question 6

Management of ARDS

Answer 6

Management in ITU

Oxygenation/ ventilation to support hypoxaemia

General organ support (vasopressins as needed)

Treatment of underlying cause

Prone positioning and muscle relxation