ACUTE RESPIRATORY DISTRESS SYNDROME 4.18.58 PM

ACUTE RESPIRATORY DISTRESS SYNDROME 4.18.58 PM - ACUTE...

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ACUTE RESPIRATORY DISTRESS SYNDROME Lyonel Carre PGY2 SICU conf 10/02/06
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ARDS Definition Severe, acute lung injury involving diffuse alveolar damage, increased microvascular permeability and non cardiogenic pulmonary edema Acute refractory hypoxemia Annual incidence 75/100,000 in the US High mortality- 40%-60% First described in 1967
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ARDS Criteria Acute onset of respiratory failure Bilateral infiltrate on CXR(some cases do present unilaterally or with pleural effusion PCWP <18 or absence of left atrial htn, PaO2/FiO2 < 200
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ARDS
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ARDS mechanism of lung injury Activation of inflammatory mediators and cellular components resulting in damage to capillary endothelial and alveolar epithelial cells Increased permeability of alveolar capillary membrane Influx of protein rich edema fluid and inflammatory cells into air spaces Dysfunction of surfactant
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ARDS causes Direct Lung Injury : a) PNA and aspiration of gastric contents or other causes of chemical pneumonitis b) pulmonary contusion, penetrating lung injury c) fat emboli d) near drowning e) inhalation injury f) reperfusion pulm edema after lung transplant
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ARDS causes Indirect lung injury a) sepsis
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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ACUTE RESPIRATORY DISTRESS SYNDROME 4.18.58 PM - ACUTE...

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