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Flashcards in FN: ARDS Deck (16):
1

Pathogenesis

􏰀 May result from direct pulmonary insult or be 2O to severe systemic illness.
􏰀 Inflam mediators → ↑ capillary permeability and non- cardiogenic pulmonary oedema.

2

Clinical FEatures

􏰀 Tachypnoea
􏰀 Cyanosis
􏰀 Bilateral fine creps
􏰀 SIRS

3

Ix


􏰀 Bloods: FBC, U+E, LFTs, clotting, amylase, CRP,
cultures, ABG.
􏰀 CXR: bilateral perihilar infiltrates

4

Dx

􏰀 Acute onset
􏰀 CXR shows bilateral infiltrates
􏰀 No evidence of congestive cardiac failure
􏰀 PaO2:FiO2

5

Mx

Admit to ITU fororgan support and Rx underlying cause

6

Ventilation
Indications
Method
SEs

􏰀 Indications
􏰁 PaO26KPa
􏰀 Method
􏰁 6ml/kg + PEEP (e.g. 10cm H2O)
􏰀 SEs
􏰁 VILI
􏰁 VAP
􏰁 Weaning difficulty

7

Circulation Mx

􏰀 Invasive BP monitoring
􏰀 Maintain CO and DO2 ̄c inotropes
􏰁 E.g. norad or dobutamine
􏰀 RF may require haemofiltration

8

Sepsis Mx

Abx

9

Other Mx

Nutritional support: enteral (best), TPN

10

Prognosis

50-75% mortality

11

Causes
Pulmonary

􏰀 Pneumonia
􏰀 Aspiration
􏰀 Inhalation injury 􏰀 Contusion

12

Causes systemic

􏰀 Shock
􏰀 Sepsis
􏰀 Trauma
􏰀 Haemorrhage and multiple transfusions
􏰀 Pancrea0titis
􏰀 Acute liver failure
􏰀 DIC
􏰀 Obs: eclampsia, amniotic embolism
􏰀 Drugs: aspirin, heroin

13

Differential dx of Pulmonary Oedema Transudates Increase capillary hydrostatic pressure

􏰁 CCF
􏰁 Iatrogenic fluid overload
􏰁 Renal failure
􏰁 Relative ↑ in negative pressure pulmonary
oedema

14

Transusdates reduced capillary oncotic pressure

􏰁 Liver failure
􏰁 Nephrotic syndrome
􏰁 Malnutrition, malabsorption, protein-losing
enteropathy

15

Tranusdates increased interstitial pressure

reduced lymphatic drainage e.g. Ca

16

Exudates differential

ARDs

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