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

  1. These toxic mediators damage the capillary and alveolar endothelium membrane
  1. This results in increased permeability of the capillary and alveolar membrane, resulting in fluid accumulation in the alveoli, causing the lungs to stiffen
  1. Injury to the alveoli causes the release of inflammatory cytokines that bring neutrophils to the lungs to release toxic mediators
  1. Because of the impaired ventilation, oxygenation is reduced
  1. The elevated pressure in the capillaries results in an increase in interstitial and alveolar edema

Progressive disorder that presents with dyspnea, tachypnea, and hypoxemia

  1. 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