ARDS (ch.18) Flashcards
(17 cards)
Why was the name changed from RDS to ARDS in 1994?
Because the condition was found to also affect children.
How is ARDS defined clinically?
Acute, noncardiogenic pulmonary edema with bilateral pulmonary infiltrates and a PaO2/FiO2 (P/F) ratio of <20
What causes ARDS?
Damage to the alveolar-capillary membrane, leading to impaired lung fluid balance and fluid leakage into alveoli
What are the two classifications of ARDS based on injury mechanism?
Primary ARDS (direct lung injury) and Secondary ARDS (indirect lung injury)
What are the three phases of ARDS progression?
Acute (Exudative), Fibroproliferative, and Chronic (Recovery) phases.
How many days is the acute/ exudative phase?
4 - 7 days
EXTRA INFO
Fluid leaks into alveoli, gas exchange is impaired, surfactant decreases, and lungs become stiff and hard to expand.
How many days is the fibroproliferative phase?
8 - 21 days
** EXTRA INFO**
Continued inflammation, fibrosis, scarring, and possible loss of alveolar function, increasing mortality risk.
How many days is the chronic/ recovery phase?
> 21 days
EXTRA INFO
Healing of lung tissue, fluid clearance, and possible development of scar tissue that can impair lung function.
How is ARDS diagnosed?
Through chest X-ray (bilateral infiltrates) and ABG (hypoxemia), along with a P/F ratio <200.
other tests that can help with diagnosis
Patient history, CBC for infection, and bronchoalveolar lavage for neutrophil activity and culture.
What are typical clinical signs of ARDS?
Tachypnea, labored breathing, hypoxemia, diminished breath sounds, and rales/crackles.
What is the initial treatment for hypoxemia in ARDS?
Supplemental oxygen, progressing to NIV or mechanical ventilation if needed.
What are the recommended low tidal volumes for ARDS ventilation?
4–8 mL/kg ideal body weight (3–6 mL/kg for poor compliance)
What SpO2 range is targeted in ARDS patients?
88% to 92%
What are acceptable blood gas targets with permissive hypercapnia?
pH > 7.20 and CO2 between 45–55 mmHg
How is Oxygenation Index (OI) calculated
OI = (FiO2 × MAP) / PaO2
What OI values guide advanced interventions like HFOV or ECMO?
HFOV if OI > 20; ECMO if OI > 40
Is inhaled nitric oxide (iNO) approved for ARDS treatment?
No, it is FDA approved only for persistent pulmonary hypertension of the newborn (PPHTN), not ARDS
