ARDS_STU2015.pdf - DEFINITION AR D S Acute(Adult...

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10/23/2015 1 A R D S Acute (Adult) Respiratory Distress Syndrome DEFINITION ARDS is a state of acute respiratory failure or a disorder resulting from an acute lung injury. ARDS is characterized by: Widespread bilateral pulmonary infiltrates Severe refractory hypoxemia Sudden and progressive non-cardiac pulmonary edema Reduced lung compliance Dyspnea ETIOLOGY Identified in last 25 years Common problem, 200 -250,000 cases yr. Mortality is 50-65% with treatment Client often young and healthy Septic shock is #1 risk factor AID’s, Multiple organ failure, DIC have poor outcome Acute injury of alveolar capillary membrane=pulmonary edema Direct damage to the alveolar-capillary gas exchange Indirect damage caused by inflammatory mediators Predisposing Conditions Infectious causes: pneumonia, TB Aspiration of fluids: gastric, drowning Trauma: head injury, burns Shock: any type Inhaled toxic agents: smoke, gases Drug overdose Trauma: pulmonary contusion, head injury Sepsis Initial damage starts inflammatory process Initial injury stimulates platelet aggregation and intravascular thrombus formation Platelets release substances that attract and activate neutrophils Neutrophils release inflammatory mediators that cause all the damage, ex. proteolytic enzymes, oxygen free radicals
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10/23/2015 2 Complication to lung tissue Inflammatory mediators cause increased alveolar-capillary permeability (hallmark of ARDS)***** Leaking of fluid and blood from capillaries to pulmonary interstitium and alveoli causes pulmonary edema and hemorrhage
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  • Spring '14
  • Brinkley
  • Acute respiratory distress syndrome, pulmonary edema

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