ARDS

Question 1

2 main steps in ARDS

Answer 1

1. initial insult

2. alveoli fill with fluid

Question 2

cause of alveoli fluid filling

Answer 2

NOT cardiogenic - due to capillary permiability

Question 3

3 pathology phases of ARDS

Answer 3

1. exudative - inflammation and edema
2. proliferative phase -
3. fibrosis

Question 4

what does endotoxin do in

Answer 4

release of tumor necrosis factor and interleukins + cytokines

Question 5

what goes to lung in ARDS

Answer 5

neutrophils - increase cap. permiability

Question 6

3 things that happen with fluid in alveoli

Answer 6

1. decr. vent > V/Q mismatch
2. shunt
3. maintained perfusion bc cytokines cause vasodilation

Question 7

4 ways to treat

Answer 7

1. oxygenate - but not over!
2. treat primary cause
3. vent if required
4. use low tidal volumes (pemissive hypercapnea)

Question 8

5 ways to support in ARDS

Answer 8

1. IV fluids
2. BP support
3. antibiotics
4. nutrition
5. care of endotracheal tube

Question 9

keys to fluids in ARDS

Answer 9

balance is keys - don’t dry out too much

Question 10

what lung volumes DON’t go down with age

Answer 10

RV

Question 11

what does lung aging resemble

Answer 11

pseudo-emphysema - less elastic as age

Question 12

what happens to vent as age (2)

Answer 12

1. response to hypercapnea blunted

2. blunted perception of dyspnea

Question 13

what happens to perfusion as age

Answer 13

more constricted

Question 14

what happens to A-a gradient as age and why

Answer 14

increases due to thicker alveoli and loss of surface area

Question 15

what happens to chest wall as age

Answer 15

no real evidence of change in compliance without disease