ACUTE RESPIRATORY DISTRESS SYNDROME

(ARDS)
Modifiable factor Non-modifiable factors

 Sepsis Lung Injury - Age: Above 65 years old

I. Injury or  Aspiration of gastric content - Gender: Male
exudative  Burns Vascular narrowing
phase  Inhalation of toxic chemicals (smoke) & obstruction

Damaged alveolar cells Bronchoconstriction Release of vasoactive substance

Surfactant production (Histamine, serotonin, bradykinin)

Alveolar compliance & recoil Alveolar capillary membrane

II. Reparative
Atelectasis or permeability

Proliferative Outward migration of blood

phase
Lung compliance Hyaline membrane cells & fluid from capillaries

Formation Impaired Gas

Impaired Exchange
Gas Exchange Pulmonary edema

III. Fibrotic or ARDS

Pulmonary
Chronic (Acute Respiratiory Distress Syndrome)
phase Hypertension

Early S/S: Complications Late S/S

-Restlessness -Nosocomial pneumonia -Severe DOB (i.e labored, rapid breathing

-Dyspnea  Chest X-ray

- Barotrauma -SOB
 Chest CT scan
Pulmonary artery
 Bronchoscopy
catheterization
 ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS)
-Low blood pressure -Renal failure -Tachycardia

-Confusion Other complications are: -Cyanosis

-Extreme tiredness - O2 toxicity -Thin frothy sputum

-Change in pt. behavior -Stress ulcer -Abnormal breath sounds

 Mood swings -Tracheal ulceration - PaCO2 with respiratory

 Disorientation - Pulmonary embolism alkalosis
 Change in LOC

-Cough

-Fever ABG analysis

Nursing intervention Medical management NCP

-Supplemental O2 -Intubation procedure -Ineffective breathing pattern r/t dec. lung compliance,

-Fluid therapy -Mechanical ventilator dec. energy as characterized by dyspnea, abnormal

-Positioning strategies -Tracheostomy ABG, cyanosis, & use of accessory muscles.

 Turn the pt. from supine -Oxygenation - Impaired gas exchange r/t diffusion defect as
to prone - PEEP characterized hypoxia (restlessness, irritability, & fear
 Another position is lateral of suffocation) hypercapnia &tachycardia.
rotation therapy - Risk for dec. cardiac output r/t positive pressure
 ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS)

ventilation.

-Ineffective protection r/t positive pressure ventilation,

dec. pulmonary compliance & inc. secretion as
characterized by crepitus, altered chest excursion,
Medications
abnormal ABG & restlessness.
-Antibiotics -Impaired physical mobility r/tmonitoring devices,
mechanical ventilation, & medications as
-Anti-inflammatory drugs (such as
characterized by imposed restrictions of movement,
corticosteroids) dec. muscle strength & limited ROM.
-Diuretics ( ) -Risk for impaired skin integrity r/t prolonged bed rest,
prolonged intubation, & immobility.
-Drugs to raise BP
-Knowledge deficit r/t health condition, new equipment
-Anti anxiety & hosp. as characterized by inc. frequency of question
posted by pt. & SO.
-Muscle relaxant

-Inhaled drugs (Bronchodilators)

 ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS)

Reference:

Legend: 1.Bernard GR, Artigas A, Brigham KL, Carlet J, Falke

Medical management K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R.
Modifiable fx The American-European Consensus Conference on
ARDS. Definitions, mechanisms, relevant outcomes,
Non-modifiable fx.
Medications and clinical trial coordination. Am J Respir Crit Care
Signs and symptoms Med 1994;149:818–824.

Nursing Intervention 2. Rubenfeld GD, Caldwell E, Peabody E, Weaver J,

Diagnostic test Martin DP, Neff M, Stern EJ, Hudson LD. Incidence
and outcomes of acute lung injury. N Engl J Med
2005;353:1685–1693.
NCP
3. The Acute Respiratory Distress Syndrome Network.
Ventilation with lower tidal volumes as compared with
traditional tidal volumes for acute lung injury and the
acute respiratory distress syndrome. N Engl J Med
2000;342:1301–1308.