Wk11 Intro to critical care Flashcards
ARDS - what is it?
diffuse inflammatory lung injury characterised by heavy lungs, reduced compliance, loss of aerated alveoli, increased dead space, and increased vascular permeability
ARDS - 3 factors
pulmonary oedema from increased alveoli capillary permeability
inflammatory infiltrates
surfactant dysfunction
ARDS - risk factors
pulmonary contusion infection - pneumonia aspiration of gastric contents fat embolism near drowning inhalation injury reperfusion injury multiple trauma major transfusion cardiopulmonary bypass pancreatitis nonpulmonary sepsis
ARDS - signs
bilateral pulmonary opacity low O2 sats acute onset non cardiac cause PaO2/FiO2ratio <300mmHg with a minimum of 5 cmH20 PEEP
ARDS - Mx
ventilation control low O2 targets position in prone Vt of 6ml/kg with high PEEP surfactant therapy glucocorticoid steroids seek and treat underlying causes/complications
Sepsis - what is it?
body attacks self after being overwhelmed by infection
Sepsis - signs
hypotension increased RR low platelets altered mental state reduced kidney function reduced liver function
Sepsis - Mx
treat infection
manage failure of other body systems
prevent secondary complications
ICU AW - what is it ?
acquired respiratory and peripheral weakness/wasting due to immobility, pathological conditions of muscle or nerves, and disuse atrophy.
ICU AW - risk factors
female older severity of illness metabolic syndromes malnutrition immobility length medications sedation
ICU AW - prevention/treatment
reduce time immobile
tight glycaemic control
reduced corticosteroid//neuromuscular blocking agent use
minimise delirium
maintain nutrition
maintain electrolyte balance
prevent need for prolonged mechanical ventilation
