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Flashcards in Acute respiratory distress syndrome Deck (19):
1

What is acute respiratory distress syndrome (ARDS)

A form of acute respiratory failure caused by permeability pulmonary oedema resulting from endothelial damage due to a cascade of inflammatory events developing in response to an initiating injury or illness

2

How does pulmonary odema arise in ARDS

Because of increased alveolar capillary permeability

3

How does pulmonary oedema arise in most situations

As a result of increased pulmonary capillary pressure (left ventricular failure)

4

What gives rise to acute lung injury

The systemic inflammatory response

5

What is a characteristic feature of permeability pulmonary oedema in ARDS

The pulmonary capillary wedge pressure is not elevated

6

What are direct causes of ARDS development

Aspiration of gastric contents or severe pneumonia or lung contusion

7

What are indirect causes of ARDS development

Systemic sepesis
Major trauma
pancreatitis

8

What are the normal features of ARDS

A history of an initiating injury or illness
hypoxaemia refractory to oxygen therapy
Bilateral diffuse infiltrates on CXR
No evidence of cardiogenic pulmonary oedema

9

What is the treatment of ARDS

Optimal management of the initiating illness or injury combined with supportive care directed at preserving adequate oxygenation, maintaining optimal haemodynamic function and compensating for multiorgan failure

10

What is the treatment of ARDS

Optimal management of the initiating illness or injury combined with supportive care directed at preserving adequate oxygenation, maintaining optimal haemodynamic function and compensating for multiorgan failure

11

What is often necessary in ARDS

Endotracheal intubation and mechanical ventilation and transfer to ITU

12

What does positive pressure ventilation do

Mechanically inflates the lungs delivering oxygen enriched air at a set tidal volume and rate

13

What is permissive hypercapnia

A technique that allows the patient to have a high PaCO2 level on order to reduce the alveolar ventilation and to avoid excessive airway pressure

14

What position should the patient be in to reduce gravity dependent fluid deposition and atelectasis

Prone posture

15

What 2 drugs should be used in ARDS

Diuretics and Vasodilators

16

What might be used as a selective pulmonary artery vasodlator

NO Nitric oxide

17

What improves oxygen carriage in the blood

Blood transfusions if the patient is anaemic

18

What is the mortality rate for patients with ARDS

More than 50%

19

WHat might patients who survive be left with

Lung fibrosis and impaired gas diffusion