Acute respiratory distress syndrome (ARDS)

From WikiCNS
Jump to: navigation, search
  1. Diffuse inflammatory process that results in endothelial damage and leaky capillary exudation into the lung parenchyma
  2. Predisposing conditions: increased ICP, pneumonia, sepsis, long bone fractures, transfusions; may occur in the first 48 hours after trauma
  3. Characterized by:
    1. Acute onset
    2. Bilateral infiltrates on chest x-ray with costophrenic angle sparing: cause high O2 requirements to maintain oxygenation
    3. Differentiate ARDS from cardiogenic pulmonary edema based on pulmonary capillary wedge pressure (PCWP); in cardiogenic edema PCWP >18, in ARDS <18
  4. Acute lung injury (ALI) vs ARDS:
    1. if PaO2:FiO2 < 300 mmHg - ALI
    2. if PaO2:FiO2 < 200 mmHg - ARDS
  5. Treatment:
    1. keep FIO2 < 50% if possible
    2. treat underlying cause
    3. avoid dopamine due to constriction of pulmonary veins which will raise the wedge pressure and increase the exudates into the lungs
Checkmark.gif This article has been reviewed by the NeuroWiki Editorial Board


Personal tools