Acute respiratory distress syndrome

Question 1

ARDS is a very _______ and can cause ________ very quickly

Answer 1

ARDS is a very devastating and cause death very quicly

Question 2

acute respiratory distress syndrome has a mortality rate of

Answer 2

30%-60%

Question 3

what is Acute respiratory distress syndrome?

Answer 3

Severe, acute onset, progressive alveoli and capillary damage (very quickly damaging)

Question 4

what is the etiology (causes) of ARDS

Answer 4

• aspiration(particularly gastric content) (or near drowning)
• trauma and shock: -fat embolus(pulmonary embolism)-burns(loss of interstitial fluid volume, develops hypovolemia leads to ARDS) - chest trauma
• infections causing septicemia (pathogens enter & survive in circulation)

-drugs, toxins & therapeutic agents: -cocaine & heroine
inhaled gases(smoke, ammonia, high concentration of 02) -radiation 

• disseminated intravascular coagulation
• multiple blood transfusions

Question 5

patho of acute respiratory distress syndrome?

Answer 5

• lung trauma then and inflammatory cell influx and then a release of free radicals, phosolipids & protease which then targets endothelial causing alveolar damage
• increase in permeability then proteins, cells & fluids move into interstitial tissue and alveoli then there is edema
• decreased compliance and impaired gas exchange
• surfacant deficiency (appearance of foreign entities decrease surfacant producation) and inactivation which leads to atelectasis (large areas)
• there is thick protein & cell rich exudate that lines alveoli so no gas exchange –THIS CAUSES PROFOUND HYPOXEMIA
• impervious hyaline membrane froms & lines alveoli (hyaline membrane is not a histological membrane forms a barrier like a membrane, but does not contain hyaline cartilage is hard impervous)

Question 6

what type of membrane froms and lines alveoli in ARDS

Answer 6

impervious hyaline membrane (but is not a histological membrane and not hyaline cartilage) froms a barrier and is hard impervious

Question 7

carbonic acid is a ______ acid therefore it indicates ____________

Answer 7

volatile

respiratory imbalance

Question 8

fixed acids indicate ________

Answer 8

metabolic acidosis (metabolic imbalance)

Question 9

what are the mnfts of ARDS?

Answer 9

• acute respiratory distress
• tachypnea (requires energy, utilizes available 02, contributes to acidosis)
• dyspnea
• marked hypoxemia
• pulmonary hypertension (may or may not develop, no useful reason bronco-constriction & vessels in pulmonary vessels constrict causing pulmonary hypertension
• early resp alkalosis
• late metabolic acidosis
• lung consolidation
• multi-organ failure

Question 10

why is early respiratory alkalosis a mnfts of ARDS

Answer 10

no carbonic acid formed due to decreased carbon dioxide (d/t hyperventilation, blowing of c02) which carbonic acid then cannot dissociate into H+ ions (acid component) (carbonic acid which means respiratory)

Question 11

what is consolidation?

Answer 11

solidification of cellular debris, exudate & proteins

Question 12

treatment of ARDS?

Answer 12

• early intervention and detection (key to survival)
• respiratory support (simplest 02 and opposite end respirator, these will work before hyaline membrane has developed, if has developed wont really work and wont be able to remove membrane permanent)
• reverse cause
• complications

Question 13

why is later metabolic aciodsis a mnfts of ARDS

Answer 13

tachypnea, working excessively, accessory muscles working hard causing hypoxemia, need oxygen moves into anaerobic respiration a by product of this is lactic acid (fixed acid) lactic acid accumulates causing (metabolic acidosis because it is a fixed acid)