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Acute Respiratory Distress Syndrome (ARDS) (Clinical Signs and Symptoms…
Acute Respiratory Distress Syndrome (ARDS)
Etiology
MOST COMMON
Sepsis
Aspiration
Pneumonia
Severe trauma
Massive blood transfusion
Lung and hematopoietic stem cell transplantation
Pathophysiology
Interstitial and intraalveolar edema and hemorrhage
Alveolar consolidation
Intraalveolar hyaline membrane formation
Atelectasis
Pulmonary surfactant deficiency or abnormality
Diagnostic Testing
CXR
Increased opacities, diffusely throughout the lungs
Ground-glass appearance :red_flag:
ABG
Mild to moderate acute respiratory distress syndrome
Acute respiratory alkalosis with hypoxemia
Severe acute respiratory distress syndrome
Acute ventilatory failure (acidosis) with hypoxemia
Differential Diagnosis
CXR
Ground-glass appearance :red_flag:
Mechanical ventilation
Lung protective strategies :red_flag:
Respiratory Management
Oxygen therapy
Treat hypoxemia
Decrease WOB
Decrease myocardial work
Lung expansion therapy
PEEP or CPAP
Mechanical ventilation
Usually needed to provide and support alveolar gas exchange
Justified when the acute ventilatory failure is thought o be reversible
Full support is recommended
Lung protective strategies are used :red_flag:
Low VT's and High RR
Clinical Signs and Symptoms
Tachypnea
Anxiety
Increased HR and BP
Cyanosis
Substernal and intercostal retractions
BS: Dull percussion, bronchial breath sounds, crackles