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Flashcards in 31. Acute respiratory distress syndrome Deck (15):
1

ARDS

Acute respiratory distress syndrome

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definition

clinical syndrome charactirized b
1. acute onset respiratory failure
2. bilateral lung opacities
3. Decreased PaO2/ FiO2 ratio
4. no HF

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ARDS is a clinical syndrome charactirized by

1. acute onset respitatory failure
2. bilateral lung opacities
3. Decreased PaO2/ FiO2 ratio
4. no HF

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ARDS may be caused by

1. trauma
2. sepsis
3. shock
4. gastric aspiration
5. uremia
6. acute pancreatitis
7. amniotic fluid embolism
8. Pneumonia

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ARDS management

1. mechanical ventilation with LOW TIDAL VOLUMES
2. address underling cause

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ARDS - pathophysiology

diffuse alveolar/ endothelial damage ---> increased capillary permeability ---> protein reach leakage into alveoli and noncardiogenic pulmonary edema ( normal PCWP) --> results in formation of intra- alveolar hyaline membranes

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ARDS - PC WP

normal ( noncardiogenic edema)

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diffuse alveolar dammage is caused by

release of neutrophilic substances toxic to alveolar wall, activation of coagaulation casxade, and oxygen - derived free radicals

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• A patient hospitalized for acute pancreatitis suddenly has difficulty breathing. PaO2:FiO2 ratio is decreased. Diagnosis?

Acute respiratory distress syndrome

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Name seven conditions known to cause acute respiratory distress syndrome.

Trauma, sepsis, shock, gastric aspiration, acute pancreatitis, amniotic fluid embolism, and uremia

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• Despite many etiologies, what pathophysiology is seen in all cases of acute respiratory distress syndrome?

Alveolar damage leads to capillary permeability, fluid leakage into alveoli, and pulmonary edema, resulting in thickened (hyaline) membranes

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• Name three molecular mechanisms that contribute to the initial damage to alveoli in acute respiratory distress syndrome.

Neutrophilic toxins, activation of the coagulation cascade, and oxygen-derived free radicals

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• An alcoholic man with acute pancreatitis and oxygen desaturation is having trouble breathing. What put him at risk for this disorder?

Pancreatitis, which triggers acute respiratory distress syndrome

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• What obstetric complication can result in adult respiratory distress syndrome?

Amniotic fluid embolism

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• A patient is diagnosed with dyspnea characterized by a decreased PaO2:FiO2 ratio. Management?

Low tidal volume mechanical ventilation, and treat underlying cause (trauma, sepsis, uremia) (this is acute respiratory distress syndrome)