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ARDS (Acute Respiratory Distress Syndrome)

ARDS (Acute Respiratory Distress Syndrome). Dr. Meg- angela Christi Amores. ARDS. clinical syndrome of severe dyspnea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure

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ARDS (Acute Respiratory Distress Syndrome)

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  1. ARDS(Acute Respiratory Distress Syndrome) Dr. Meg-angela Christi Amores

  2. ARDS • clinical syndrome of severe dyspnea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure • The arterial (a) PO2 (in mmHg)/FIO2 (inspiratory O2 fraction) <200 mmHg is characteristic of ARDS

  3. ARDS • caused by diffuse lung injury from many underlying medical and surgical disorders

  4. ARDS • >80% are caused by severe sepsis syndrome and/or bacterial pneumonia (~40–50%), trauma, multiple transfusions, aspiration of gastric contents, and drug overdose • older age, chronic alcohol abuse, metabolic acidosis, and severity of critical illness

  5. ARDS • Natural history is marked by 3 phases:

  6. Exudative Phase • alveolar capillary endothelial cells and type I pneumocytes (alveolar epithelial cells) are injured • Edema fluid • Cytokines • first 7 days of illness • Dyspnea develops

  7. Proliferative Phase • lasts from day 7 to day 21 • Most recover rapidly, off ventilation • many still experience dyspnea, tachypnea, and hypoxemia • first signs of resolution • proliferation of type II pneumocytes along alveolar basement membranes

  8. Fibrotic Phase • require long-term support on mechanical ventilators and/or supplemental oxygen • extensive alveolar duct and interstitial fibrosis • emphysema-like changes with large bullae

  9. Treatment • General Principles • (1) the recognition and treatment of the underlying medical and surgical disorders (e.g., sepsis, aspiration, trauma); • (2) minimizing procedures and their complications; • (3) prophylaxis against venous thromboembolism, gastrointestinal bleeding, and central venous catheter infections; • (4) the prompt recognition of nosocomial infections; and • (5) provision of adequate nutrition

  10. Management of Mechanical Ventilation

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