ARDS

Question 1

What happens in Acute Respiratory Distress Syndrome (ARDS)?

Answer 1

• increased permeability of alveolar capillaries
  => fluid accumulation in the alveoli

i.e. non-cardiogenic pulmonary oedema

Question 2

What conditions can cause ARDS?

Answer 2

Infection
massive blood transfusion
trauma
smoke inhalation
acute pancreatitis
Covid-19
cardio-pulmonary bypass

Question 3

Describe the clinical features seen in ARDS

Answer 3

Acute onset and severe:
- dyspnoea
- high RR
- bilateral lung crackles
- low oxygen saturations

Question 4

Key investigations in ARDS

Answer 4

chest x-ray
Arterial blood gases

Question 5

Criteria for ARDS diagnosis

Answer 5

• Acute onset (within 1 week of risk factor)
• pulmonary oedema: bilateral infiltrates on chest x-ray
• non-cardiogenic
• pO2/FiO2 < 40kPa (300 mmHg)

Question 6

Management of ARDS

Answer 6

• usually in ITU
• oxygen/ventilation
• organ support
• attempt to treat cause - e.g. Abx for sepsis