RESPIRATORY

DISTRESS
SYNDROME
(ARDS)
Alka.S.Kandula
ROLL No: 6
 RESPIRATORY DISTRESS SYNDROME
(ARDS)
 Acute respiratory distress syndrome (ARDS) is a life-threatening lung
condition that prevents enough oxygen from getting into the blood.
 Acute respiratory distress syndrome was first described in 1967 by
Ashbaugh and colleagues.
 ARDS is also referred with variety of terms like:
• Stiff Lung
• Shock Lung
• Wet Lung
• Post traumatic lung
• Adult respiratory distress syndrome
• Adult hyaline membrane disease
• Capillary leak syndrome
• Congestive atelectasis
 DEFINITION
 Acute respiratory distress syndrome (ARDS) is
a sudden and progressive form of acute
respiratory failure in which the alveolar
capillary membrane becomes damaged and
more permeable to intravascular fluid resulting
in severe dyspnea , hypoxemia and diffuse
pulmonary infilrates.
 ETIOLOGY AND RISK FACTORS
 Direct Lung Injury
-Common causes
• Aspiration of gastric contents or other substances.
• Viral/bacterial pneumonia
-Less Common causes
• Chest trauma
• Embolism : fat , air , amniotic fluid
• Inhalation of toxic substances
• Near-drowning
• O2 toxicity
• Radiation pneumonitis
ETIOLOGY AND RISK FACTORS
 Indirect Lung Injury
-Common causes
• Sepsis
• Sereve traumatic injury
-Less Common causes
• Acute pancreatitis
-Less Common causes
• Anaphylaxis
• Prolonged Cardiopulmonary bypass surgery
• Disseminated intravascular coaglation
• Multiple blood transfusion
• Narcotic drug overdose (example - heroine)
• Nonpulmonary systemic disease
• Severe head injury
• Shock
• Massive blood transfusion
STAGES OF ODEMA FORMATION IN
ARDS
SCHEMATIC REPRESENTATION OF
PATHOPHYSIOLOGY OF ARDS
 CLINICAL MANIFESTATION
 Early signs/symptoms
• Restlessness
• Dyspnea
• Lowbloodpressure
• Confusion
• Extreme tierdness
• Change in patient’s behvior
 Mood swing
 Disorientation
 Change in LOC
• If tneumonia is causing ARDS then client may have
 Cough
 Fever
 CLINICAL MANIFESTATION
 Late signs/symptoms
• Severe difficulty in breathing i.e, laboured rapid , breathing.
• Shortness of breath.
• Tachycardia
• Cyanosis (blue skin, lips and nails)
• Think frothy sputum
• Metabolic acidosis
• Abnormal breath sounds, like crackles
PaCo2 with respiratory alkalosis
PaCo2
 DIAGNOSTIC EVALUTION
 On physical examination
 Auscultation reveals abnormal breath sounds
 The first tests done are :
 Arterial blood gas analysis
 Blood tests
 Chest x-rays
 Bronchoscopy
 Sputum cultures and analysis
• Other tests are :
 Chest CT scan
 Echocardiogram
 COMPLICATIONS
 Common complications are:
 Nosocomial pneumonia:
 Barotrauma
 Renal failure
 other complications are:
 O2 toxicity
 Stress ulcers
 Tracheal ulceration
 Blood clots leading to deep vein thrombosis
 Pulmonary embolism
 MEDICAL MANAGEMENT
 Persons with ARDS are hospitalized and require
treatment in an intensive care unit.
 No specific therapy for ARDS exists.
 Supportive measures:
 Supplemental oxygen
 Mechanical respirator
 Positioning strategies
 Turn the patient from supine to prone.
 Another position is lateral rotation therapy
 MEDICAL MANAGEMENT
 MEDICATIONS:
 Antibiotics
 Anti-inflammatory drugs; such as corticosteroids
 Diuretics
 Drug to raise blood pressure
 Anti-anxiety
 Muscle relaxers
 Inhaled drugs (Bronchodilators)
 PATIENT LYING PRONE ON
VALLMAN PRONE POSITIONER
THANK YOU