Acute Respiratory Distress Syndrome

Question 1

What is the aetiology of acute respiratory distress syndrome?

Answer 1

Increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli (i.e. non-cardiogenic pulmonary oedema).

Question 2

What are the causes of acute respiratory distress syndrome?

Answer 2

1. Sepsis, pneumonia
2. Massive blood transfusion
3. Trauma, smoke inhalation
4. Acute pancreatitis

Question 3

What is this a presentation of?

Acute and severe dyspnoea and tachypnoea, bilateral lung crackles, low oxygen sats (hypoxaemia).

Answer 3

Acute respiratory distress syndrome

Question 4

How is suspected acute respiratory distress syndrome investigated?

Answer 4

1. FBC, U&Es, LFTs, amylase, clotting, CRP, blood cultures
2. Pulmonary artery wedge pressure to confirm non-cardiogenic origin
3. CXR
4. ABG

Question 5

What is the management of acute respiratory distress syndrome?

Answer 5

1. Manage in ITU
2. Oxygenation/ventilation to treat hypoxia
3. Organ support - vasopressors
4. Treat underlying cause (e.g. antibiotics)