Acute Respiratory Distress Syndrome
Acute Respiratory Distress Syndrome (ARDS)
Acute,diffuse,inflammatory lung injury associated with variety of etiologies.
Clinical diagnosis (Berlin definition)
All of the following criteria should be present
1. Respiratory Distress within 7 days.
2. Bilateral lung opacities on chest xray or CT.
3. Respiratory failure not explained by heart failure or volume overload.
4. PaO2/FiO2 < 300
Severity of ARDS (based on PaO2/FiO2)
-
Mild : > 200 <= 300
-
Mod : > 100 <= 200
-
Sev : <= 100
Note - if ABG is not available then in place of PaO2/FiO2 , SaO2/FiO2 can also be taken with value 315.
Etiology
-
Direct - Pneumonia, Aspiration, Inhalational lung injury, Chest trauma, Near drowning
-
Indirect - Sepsis, Shock, Trauma, Cardiopulmonary bypass, TRALI, Burns, Increased ICT.
Pathophysiology
Fluids accumulation in the lungs not explained by heart failure ( noncardiogenic pulmonary edema). Triggering event is cytokine mediated endothelial leak followed by migration of inflammatory cells.
Complications
-
Lung - pulmonary embolism, barotrauma, VAP
-
GI - ulcer , bacterial translocation, bleeding
-
Neuro - Hypoxic brain injury
-
Cardiac - arrhythmia, myocardial dysfunction
-
Renal - AKI
-
Others - malnutrition, pneumothorax, electrolyte imbalance, atelectasis, multiorgan dysfunction, DVT,etc
Management
-
Usually supportive. If etiology found then treating etiology like sepsis with antibiotics.
-
Mechanical ventilation- Low tidal volume
-
Usually no role of corticosteroids.
-
others
-
Sedation
-
Muscle relaxant
-
Fluid management
-
Nutrition
-
Prone ventilation
-
Extracorporeal membrane oxygenation (ECMO)
Prognosis
Poor with mortality more than 40%
Useful Links
Useful Videos
- Immunoglobulins
- Chromosomal Abnormalities
- Cranial Nerves - Part 1
- Disease Cycle
- IV Cannula - Color Coding
- 10 Important Scientists
- Identify the condition - Part 1
- Common Clinical Symptoms - Part 1
- Acid Base Balance - Part 1
- Acid Base Balance - Part 2
- Acid Base Balance - Part 3
- Acid Base Balance - Part 4
- Fetal Circulation
- Pediatric Drug Dose Calculation
- Drug Antidotes
- Drugs causing Gynecomastia
.................................
Must have books
All medical students should have these books
- Anatomy - B D Chaurasia
- Physiology - Guyton
- Pathology - Gobind Rai Garg
- Medicine - Davidson's
- Key to Success Staff Nurses Recruitment Exam
.................................
Specially for Medical Mothers
Items useful for mothers
.................................
Specially for Medical Fathers
Items useful for fathers
................................
Motivate us
If you like our efforts you may motivate us through following methods
- Subscribe our YouTube channel
- Subscribe our Facebook page
- Like & share our website & youtube videos
- Make purchases through our store
- Contribute through Motivate us page
.................................
Have any query?
If you have any query you may contact us through any of the following options
- Email us on staffnurseexam@gmail.com
- Fill this form - Contact us
- Write in Comments section of Youtube Videos