ARDS

Question 1

Characteristics of ARDS

Answer 1

Diffuse alveolar damage, increased capillary permeability, pulmonary edema

Question 2

Do ARDS patients respond to supplemental 02?

Answer 2

No

Question 3

ARDS criteria

Answer 3

Acute onset, Pulmonary capillary wedge pressure less than 18, PaO2/FiO2 is less than 200.
The PCWP is a surrogate measurement of left atrial pressure, if it is high (over 18) it can mean that you have volume overload in the heart and that may be the cause of your pulmonary edema.

Question 4

Mechanism of injury

Answer 4

inflammatory mediators activate –> damage capillary endothelium and alveolar epithelium.
Inc cap permeability–> Protein rich fluid in air space–> disruption of surfactant which means lungs tend to collapse.

Question 5

Causes

Answer 5

Direct and indirect causes;
Direct lung injury–> pneumonia, aspiration, pulmonary contusion, fat emboli, inhalation, near drowning.
Indirect–> sepsis, trauma, drug o/d, pancreatitis

Question 6

Stages of ARDS

Answer 6

Bards….shakespeare….member 0-4, 4-8, 8.

Exudative, proliferative, fibrotic

Question 7

Lung injury score

Answer 7

4 points, 1-2.5 is mild or moderate, 2.5-4 is severe
1= chest x-ray
2= PaO2: FiO2
3= PEEP
4= Respiratory compliance

Question 8

Remember there is an acute decrease in compliance!

Answer 8

v

Question 9

significant reduction in mortality achieved with?

Answer 9

Lower tidal volume.

Question 10

Incidence of pneumothorax seen when

Answer 10

After two weeks of ARDS onset

Question 11

Death in ARDS patient usually seen as a result of Multi-organ failure

Answer 11

true

Question 12

Most common etiologic agent

Answer 12

Strep pneumo