Adult (Acute) Respiratory Distress syndrome

Definition: It is a clinical syndrome also known as noncardiogenic pulmonary edema

characterized by a progressive decrease in arterial Oxygen content occurring after a
serious illness or injury.

Assessment:
 Factors related to ARDS
1. aspiration of gastric secretions, drowning, hydrocarbons
2. Drug ingestion and overdose
3. Hematologic disorders (DIC, massive transfusions)
4. Prolonged inhalation of high concentration of Oxygen, smoke or corrosive
substances
5. Shock
6. Trauma (multiple fractures, head injury)
7. Major Surgery
8. fat or Air embolism
 Manifestations: Severe dyspnea, refractory hypoxemia, diffuse
bilateral infiltrates

Diagnostic tests:
1. Arterial Blood Gas Analysis
2. Pulse Oximeter for Oxygen Saturation
3. Obtain Pulmonary Artery wedge pressure
4. Chest X-ray

Medical Management:
1. Provide adequate ventilation either by mechanical ventilation, ET intubation and
PEEP.
2. Administer Nitric Oxide because it causes vasodilation of the capillary beds of the
lungs and helps reduce the pressure in the pulmonary arteries.
3. Administer N-Acetylcysteine and procysteine to help reduce the degradative
effects of the proteases.
4. Administer antibiotics to treat respiratory tract infections.
5. Thoracentesis can be performed.
6. Chest Tube Thoracotomy is done to reduce fluid accumulation in the lungs.

Nursing Management
1. If the patient is not on mechanical ventilation, place himon semi or high-fowlers
position to allow maximum excursion of the thorax.
2. If the fluids are not restricted, encourage to increase fluid intake to help loosen
secretions.
3. Provide adequate rest for conservation of Oxygen Use.
4. Reposition the client every 2 hours to help in the drainage of secretions.