Acute Respiratory Distress Syndrome (ARDS)

Question 1

What is Acute Respiratory Distress Syndrome (ARDS)?

Answer 1

Respiratory failure from overwhelming lung injury of systemic disease leading to severe hypoxia

Question 2

What illnesses and injuries are commonly associated with Developing ARDS?

Answer 2

Sepsis/aspiration
Lung contusion/trauma
near-drowning
burns/pancreatitis

Question 3

What is ARDS defined as clinically?

Answer 3

pO2/FIO2 ratio <300
-ratio of arterial oxygen pressure to fractional inspired oxygen

Question 4

What is the underlying pathology of ARDS?

Answer 4

ARDS decreases surfactant and makes the lung cells “leaky” causing the alveoli to fill up with fluid

Question 5

What is seen on CXR in ARDS?

Answer 5

bilateral infiltrates that quickly become confluent “white-out lung”

Air bronchograms are common

Question 6

How do you treat ARDS?

Answer 6

Treat the underlying cause

Low tidal-volume mechanical ventilation: 6mL/kg ideal body weight

PEEP to decrease FIO2: maintain plateau pressure <30cm of Water

Prone positioning

Question 7

What should you keep tidal volume to in ARDS?

Answer 7

Low: 6mL/kg to avoid overinflation which increases mortality

Question 8

What FIO2 is associated with oxygen toxicity?

Answer 8

FIO2 > 50%

Question 9

What can you increase to keep the FIO2 below 50%?

Answer 9

Positive End-Expiratory Pressure (PEEP)