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ARDS (CLINICAL SIGNS AND SYMPTOMS (dyspnea, cyanosis, bilateral crackles,…
ARDS
CLINICAL SIGNS AND SYMPTOMS
dyspnea
cyanosis
bilateral crackles
tachypnea
tachycardia
diaphoresis
use of accessory muscles
cough
chest pain
ETIOLOGY
sepsis
aspiration
pneumonia
severe trauma
massive blood transfusion
lung and hematopoietic stem cell transplantation
drug abuse
DIFFERENTIAL DIAGNOSIS
respiratory failure
salicylate toxicity
bacterial pneumonia
toxic shock syndrome
VAP
hemorrhagic shock
PATHOPHYSIOLOGY
interstitial and intraalveolar edema and hemorrhage
alveolar consolidation
pulmonary surfactant deficiency or abnormality
atelectasis
DIAGNOSTIC TESTS
chest radiograph
specific symptom criteria
echocardiogram to rule out heart failure or fluid overload
PaO2/FIO2 ratio
MILD: >200 but less than 300
MODERATE: <200 with peep 5 or higher
SEVERE: <100 with peep 5 or greater
RESPIRATORY MANAGEMENT
O2 therapy
lung expansion
mechanical ventilation
low tidal volume
high rates
plat 25-30 cm H2O