ARDS

BYsimon
ARDS( acute respiratory distress syndrome) is
characterized by hypoxemia and decreased
pulmonary compliance : 1). bilateral infiltrat are
present on the chest x-ray 2). The PaO2/FIO2
ratio ≤ 200, 3). No evidence of left heart failure,
4). Acute.
ALI ( acute lung injury ) is similar to ARDS,
except that the PAO2/FIO2 is ≤300.
 Indication for mechanical
ventilation in patiens with ARDS
Increased work-of-breathing
Oxygenation impairment
Impending ventilatory failure
Acute ventilatory failure
 Ventilator setting for ARDS
Mode : A/C (CMV ) in most acute stages;
pressure support in early stages and
during recovery
Rate : as high as 35/min; avoid auto-PEEP
Volume/pressure control : Pressure
Tidal volume : 4-8 ml/kg and plateau
pressure < 30 cm H2O
Inspiratory time : set to insure synchrony in
patient-triggered ventilation, incorporate a short
end-inspiratory pause in passive ventilation (
0.1-0.3 s )
PEEP : 10-20 cm H2O
FIO2 : as needed to achive SpO2/PaO2 target
Mean airway pressure : Lowest level to achive
SpO2/PaO2 target( 20-25 cmH2O may be
required )