ARDS

Question 1

Form of noncardiogenic pulmonary edema that results from acute alveolar damage.
Characteristics: acute diffuse, infiltrative lung lesions, interstitial and alveolar edema, severe hypoxemia, and respiratory failure

Answer 1

Acute Respiratory Stress Syndrome (ARDS)

Question 2

Per the Berlin Definition of ARDS, for it to be “acute”, you must develop signs within ___ of the primary cause

Answer 2

1 wk

Question 3

Berlin Definition of ARDS

Answer 3

1. must be within 1 wk of cause
2. PaO2/FiO2 ratio ≤ 300 mmHg
3. AP CXR shows bil infiltrates

PaO2/FiO2 = ratio of partial pressure of O2 in the blood vs fractional inspired air

Question 4

ARDS

Pathophysiology

Answer 4

Lung injury → alveoli swell → disrupts surfactant → alveoli collapse (atelectasis) → O2 cannot perfuse (ventilation-perfusion rate uneven) → SHUNT -> blood in lungs backs up -> blood in pulm a. cannot go into lungs -> pulm HTN

Question 5

CXR Findings: Alveolar infiltrates (cotton balls)

Answer 5

ARDS

Question 6

ARDS WU

Answer 6

CXR
ABG
Blood & urine cultures
BNP - elev in HF
Lactate level - elev in sepsis

Question 7

Trmnt

Answer 7

1. High-flow O2 therapy
2. Mechanical vent if O2 sat <90% despite trying #1

Question 8

Purpose of PEEP?

Answer 8

• (PEEP) Positive end-expiratory pressure is given to patient’s to keep their alveoli from collapsing when inhaling AND exhaling
• PEEP should be set slightly lower than pt’s norm % pressure. Want it high enough to keep alveoli open but not TOO high -> rupture*

Question 9

nasal cannula O2 flow:
anything greater than ____% FiO2 is useless

Answer 9

40%
only need enough to fill nasopharynx