All::Respiratory::Diseases::Acute respiratory distress syndrome
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What are the main clinical features of Acute respiratory distress syndrome?
- dyspnoea
- elevated respiratory rate
- bilateral lung crackles
- low oxygen saturations
What is the management of Acute respiratory distress syndrome?
- due to the severity of the condition patients are generally managed in ITU
- oxygenation/ventilation to treat the hypoxaemia
- general organ support e.g. vasopressors as needed
- treatment of the underlying cause e.g. antibiotics for sepsis
- certain strategies such as prone positioning and muscle relaxation have been shown to improve outcome in ARDS
What are the main causes of Acute respiratory distress syndrome?
- infection: sepsis, pneumonia
- massive blood transfusion
- trauma
- smoke inhalation
- acute pancreatitis
- Covid-19
- cardio-pulmonary bypass
What is the pathophysiology of Acute respiratory distress syndrome?
increased permeability of alveolar capillaries leading to fluid accumulation in the alveoli, i.e. non-cardiogenic pulmonary oedema
Acute respiratory distress syndromeWhat are the common complications of Acute respiratory distress syndrome?
mortality of around 40%
Acute respiratory distress syndromeWhat is the diagnostic criteria of Acute respiratory distress syndrome?
- acute onset (within 1 week of a known risk factor)
- pulmonary oedema: bilateral infiltrates on chest x-ray ('not fully explained by effusions, lobar/lung collapse or nodules)
- non-cardiogenic (pulmonary artery wedge pressure needed if doubt)
- pO2/FiO2 < 40kPa (300 mmHg)