Acute Respiratory Distress Syndrome
Etiology & Pathophysiology
Collaborative Treatments
Signs & Symptoms
Labs & Diagnostics
Complications
Risk Factors
Critical illness
Alcoholism
Hx of septicemia
Smoking
Obesity
AKI
Stress ulcers
Respiratory failure
Venous thromboembolism
Pulmonary fibrosis
Permanent lung disease & lung scarring
Cognitive problems
WORST= death
HALLMARK SIGN= Hypoxemia refractory to oxygen therapy
Altered mental status
SOB & increased WOB
Peripheral cyanosis
Tachypnea
Rapid onset
Multisystem organ failure
ABGs (hypoxemia & respiratory alkalosis; later acidosis)
Chest X-Ray (diffuse bilateral infiltrates, opacities)
CBC
CT scan
Echocardiogram
PAWP catheter (<18)
Pneumothorax
Barotrauma
Depression & PTSD
Mechanical ventilation
Prone positioning
Possible fluid administration
Broad spectrum antibiotics
Corticosteroids in the early stages
pH neutralizer (ranitidine)
Enteral tube feedings
Early mobilization
Dyspnea
Crackles
Diminished lung sounds
Decreased O2 sats
Lethargy
Blood culture
High flow nasal cannula
ROM
- These toxic mediators damage the capillary and alveolar endothelium membrane
- This results in increased permeability of the capillary and alveolar membrane, resulting in fluid accumulation in the alveoli, causing the lungs to stiffen
- Injury to the alveoli causes the release of inflammatory cytokines that bring neutrophils to the lungs to release toxic mediators
- Because of the impaired ventilation, oxygenation is reduced
- The elevated pressure in the capillaries results in an increase in interstitial and alveolar edema
Progressive disorder that presents with dyspnea, tachypnea, and hypoxemia
- When alveolar pressure exceeds that of pulmonary pressures, the alveoli close and collapse
Causes= Pneumonia, sepsis, aspiration, trauma, drowning, pancreatitis, narcotic or salicylate overdose, smoke inhalation
Lung stiffness
Increased pulmonary arterial pressure