Acute Respiratory Distress Syndrome (ARDS)

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Questions and Answers

What characterizes Acute Respiratory Distress Syndrome (ARDS)?

Lung inflammation solely caused by viral infections

Slow onset of symptoms primarily caused by allergies

Abrupt loss of lung function with gradual recovery

Rapid onset of difficulty breathing and low blood oxygen levels (correct)

Which of the following is a common direct cause of ARDS?

Chronic obstructive pulmonary disease

Asthma exacerbation

Pneumonia (correct)

Hypertension

How is the severity of ARDS classified?

By the amount of fluid in the lungs

By observing the patient's heart function

Based on the patient's age and medical history

According to the PaO2/FIO2 ratio (correct)

Which phase of ARDS is characterized by extensive scarring and chronic respiratory issues?

Fibrotic phase Signup and view all the answers

What is critical for diagnosing ARDS?

Determining the PaO2/FIO2 ratio within a specific timeframe Signup and view all the answers

Which medical condition can lead to indirect lung injury in ARDS?

Sepsis Signup and view all the answers

What is the primary goal of mechanical ventilation in ARDS management?

To support patients with respiratory fatigue Signup and view all the answers

In which phase of ARDS does lung repair and tissue organization primarily occur?

Proliferative phase Signup and view all the answers

What is the recommended tidal volume for minimizing ventilator-induced lung injury in ARDS patients?

6 mL/kg of predicted body weight Signup and view all the answers

Which of the following treatments has not shown consistent mortality benefit in ARDS management?

Glucocorticoids Signup and view all the answers

How does prone positioning affect ARDS patients?

It improves oxygenation in severe cases. Signup and view all the answers

What is the estimated mortality rate for patients with moderate ARDS?

40% Signup and view all the answers

Which factor is associated with poorer pulmonary function recovery after ARDS?

Low lung compliance Signup and view all the answers

What is a potential rescue therapy for severe cases of ARDS?

Extracorporeal membrane oxygenation (ECMO) Signup and view all the answers

Which of the following is a common non-pulmonary cause of death in ARDS patients?

Sepsis Signup and view all the answers

What long-term issues might ARDS survivors face after recovery?

Potential psychological distress Signup and view all the answers

Study Notes

Acute Respiratory Distress Syndrome (ARDS)

Severe lung condition marked by rapid breathing difficulty, low blood oxygen, and widespread lung inflammation.
Leads to respiratory failure, stemming from direct or indirect lung damage.
Severity categorized as mild, moderate, or severe based on hypoxemia levels (blood oxygen levels).

Common Causes of ARDS

Direct Lung Injuries: Pneumonia, aspiration, toxic inhalation, lung contusion.
Indirect Lung Injuries: Sepsis, severe trauma, multiple transfusions, drug overdose, and pancreatitis.
Multiple predisposing conditions increase risk.

Diagnosis of ARDS

Acute onset of respiratory symptoms (within a week of initial insult).
Low blood oxygen levels (measured by PaO2/FIO2 ratio).
Bilateral lung opacities on imaging, not explained by other issues like heart failure or fluid overload.
PaO2/FIO2 ratio categorizes severity: mild (200-300 mmHg), moderate (100-200 mmHg), or severe (≤100 mmHg) measured while the patient is on PEEP (Positive End-Expiratory Pressure) of minimum 5cm H2O.
Consider alternative diagnoses like cardiogenic pulmonary edema, pneumonia, or alveolar hemorrhage.

Phases of ARDS Progression

Exudative Phase: (approx. 1 week) - Lung damage, fluid/protein buildup, inflammation.
Proliferative Phase: (7-21 days) - Repair & tissue organization; most recoveries occur.
Fibrotic Phase: (> 3 weeks) - Extensive scarring (fibrosis); potential for chronic respiratory problems.

Mechanical Ventilation in ARDS Management

Necessary for patients with respiratory fatigue.
Aims to minimize ventilator-induced lung injury (volutrauma & atelectrauma).
Strategies involve low tidal volumes (6 mL/kg predicted body weight) and lower airway pressures.
Positive End-Expiratory Pressure (PEEP) crucial to prevent alveolar collapse and improve oxygenation.
Prone positioning can aid oxygenation in severe cases.

Other ARDS Treatments

Addressing underlying causes.
General critical care support (e.g., blood clots, GI bleeds).
Minimizing unnecessary procedures.
Adequate nutrition and careful fluid management.
Neuromuscular blockade for severe ventilator dyssynchrony.
Glucocorticoids generally not recommended.
Surfactant replacement and pulmonary vasodilators are not consistently effective to improve survival.
Extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severe cases.

ARDS Prognosis

Mortality rates vary by severity: 35% (mild), 40% (moderate), and 46% (severe).
Improving rates observed over time.
Non-pulmonary causes (sepsis, organ failure) account for many deaths.
Older age, pre-existing conditions, and direct lung injury increase risk.
Most survivors recover near-normal lung function, but quality of life may be affected.

Factors Affecting Functional Recovery

Extent of early lung injury crucial to functional recovery.
Factors like low lung compliance, high PEEP, longer mechanical ventilation, and higher lung injury scores correlate with poorer functional recovery.
Long-term limitations in fitness and possible psychological distress possible post-recovery.

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Description

Test your knowledge on Acute Respiratory Distress Syndrome (ARDS), a severe lung condition characterized by rapid breathing difficulties and low blood oxygen levels. This quiz covers causes, diagnosis, and severity classification of ARDS. Assess your understanding of this critical health issue related to respiratory failure.