Acute respiratory distress syndrome

Posted by e-Medical PPT
Acute respiratory distress syndrome (ARDS)is a serious reaction to various forms of injuries to the lung.ARDS is a severe lung disease caused by a variety of direct and indirect issues. It is characterized by inflammation of the lung parenchyma leading to impaired gas exchange with concomitant systemic release of inflammatory mediators causing inflammation, hypoxemia and frequently resulting in multiple organ failure. This condition is often fatal, usually requiring mechanical ventilation and admission to an intensive care unit.
ARDS formerly most commonly signified adult respiratory distress syndrome to differentiate it from infant respiratory distress syndrome in premature infants. However, as this type of pulmonary edema also occurs in children, ARDS has gradually shifted to mean acute rather than adult.

ARDS is characterized by:
    * Acute onset
    * Bilateral infiltrates on chest radiograph sparing costophrenic angles
    * Pulmonary artery wedge pressure < 18 mmHg (obtained by pulmonary artery catheterization), if this information is available; if unavailable, then lack of clinical evidence of left ventricular failure suffices
    * if PaO2:FiO2 less than 300 mmHg (40 kPa) acute lung injury (ALI) is considered to be present
    * if PaO2:FiO2 less than 200 mmHg (26.7 kPa) acute respiratory distress syndrome (ARDS) is considered to be present
ARDS patients usually presents with shortness of breath, tachypnea and occasionally confusion resulting from low oxygen levels.
ARDS can occur within 24 to 48 hours of an injury (trauma, burns, aspiration, massive blood transfusion, drug/alcohol abuse) or an acute illness (infectious pneumonia, sepsis, acute pancreatitis).
An arterial blood gas analysis and chest X-ray allow formal diagnosis by the aforementioned criteria.


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