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Adult Respiratory Distress Syndrome

Adult Respiratory Distress Syndrome. Kathy Plitnick RN PhD CCRN NUR 351 Critical Care Nursing. ARDS. Form of acute noncardiogenic pulmonary edema Occurs secondary to another event

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Adult Respiratory Distress Syndrome

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  1. Adult Respiratory Distress Syndrome Kathy Plitnick RN PhD CCRN NUR 351 Critical Care Nursing

  2. ARDS • Form of acute noncardiogenic pulmonary edema • Occurs secondary to another event • Increased capillary permeability that precipitates a condition – lungs become wet, heavy, congested, hemorrhagic, stiff & unable to diffuse oxygen

  3. Precipitating Event • Direct Pulmonary injury: aspiration, near drowning, pneumonia, trauma, embolism, O2 toxicity, smoke inhalation • Indirect: sepsis, pancreatitis, massive blood transfusions, multiple trauma, DIC, shock, CPB, anaphylaxis

  4. Lung Injury • Neutrophils release chemical mediators • Increase in capillary membrane permeability • Fluids & proteins leak into pulmonary interstitium/alveoli • Alveoli collapse • Severe hypoxemia & decreased lung compliance

  5. Lung Injury • Bronchoconstriction • Destroyed elastin and collagen fibers of the lung • Edema & scarring of lungs • Microemboli form • Fibrotic changes

  6. Physiologic Manifestations • Stiff Lungs • Shunting • Increased alveolar deadspace ventilation • V/Q mismatching • Bronchovascular edema

  7. Clinical Manifestations • Dyspnea, tachypnea • Tachycardia, decreased BP • Mental status changes • Crackles, wheezes • ABG’s, CXR • PFT – decreased VC, VE, FRC

  8. Treatment • Supportive • Mechanical Ventilation • PEEP • Prone Positioning • Therapeutic • Fluids & Electrolytes • Nutrition • Sedation • Inotropes • Curative • Treat underlying cause

  9. Other Therapies • Medications • NSAIDS • Surfactact Replacement • Antioxidants • Inhaled Nitric Oxide • Liquid Ventilation • ECMO/IVOX

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