acute respiratory distress syndrome (ards)

ACUTE RESPIRATORY DISTRESS SYNDROME ARDS_ Presented and Modified by: Christopher W.. • Total body system shock• Etiology: Severe CNS Disorder, Trauma, CVA, Inc... • Physiologic alteratio

ACUTE RESPIRATORY DISTRESS SYNDROME

(ARDS)_

Presented and Modified by:

Christopher W Blackwell, ARNP, MSN, PhD(c)

• Noncardiac pulmonary edema

• A form of respiratory failure

• Complication of hospitalized patients

– Serious med-surg problem

– May not be lung related

– Mortality remains 50-60%

• Total body system (shock)

• Etiology: Severe CNS Disorder, Trauma, CVA, Inc CSF

– Abnormal gas exchange

– Intrapulmonary shunting

– Reduced lung compliance

• Decreased surfactant activity

1 Amt of Infiltrates on CXR.

• Physiologic alterations

– Injury to pulmonary endothelium and alveolar epithelium causes increase in lung permeability – Fluid leaks into interstitial spaces causing

pulmonary edema

– INCIDENCE AND PREVALENCE

• Physiologic alterations

– Injury to Type II pneumocytes, causes increase

in surface tension and atelectasis

– Alveolar-capillary membrane damage,

inflammation occurs, substances gather at site

of injury decreasing gas exchange

3 PCWP <18mm Hg (or more easily

understood, no clinical evidence of L

Atrial HTN).

• Results of physiologic alterations

– Ventilation-perfusion anomalies

– Decreased lung compliance

– Increase work of breathing

• No single exogenous or endogenous

precipitating factor Multiple causes.

• Exact causative mechanism is unknown

• Direct and Indirect Causes

• Pulmonary related

Clinical manifestations

• Acute respiratory failure

– Change in Personality, disorientation, dec

• PaCO2 dec. Resp Alkalosis (initial);

• Lactic Acid Met Acidosis (later)

Diagnostic studies

• Radiologic

– CXR

• Diffuse, bilateral infiltrates

• Laboratory

– ABGs

Phases of ARDS

• Phase I

– Client exhibits dyspnea and tachypnea

• Support client with oxygenation

• Phase 2

– Increasing pulmonary edema

• Mechanical ventilation support

• Vent Settings should be Lung-Protective.

• Unconventional Modes (High Frequency

Ventilation, Pressure-Controlled

Ventilation, and Inverse-Ratio Ventilation) have failed to demonstrate efficacy and are not standard acceptable Tx.

9 months- 4 years after lung injury show a

mild restrictive