acute respiratory distress syndrome (ards)

ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)_ Presented and Modified by: Christopher W Blackwell, ARNP, MSN, PhD(c) Based on: Materials Prepared by: Lucy Baccus Stella, RN, MN and Introduction to Critical Care Nursing (3rd Edition) Sole, Lamborn, Hartshorn (2001) 08/12/14 LBS Definition • Noncardiac pulmonary edema • A form of respiratory failure • Complication of hospitalized patients – Serious med-surg problem – May not be lung related – Mortality remains 50-60% 08/12/14 LBS Pathophysiology • Frequently associated – Low perfusion • Single organ • Multi-organ (MODS) • Total body system (shock) • Etiology: Severe CNS Disorder, Trauma, CVA, Inc CSF • Hallmark of ARDS – Hypoxia 08/12/14 LBS Pathophysiology • Other characteristics – Severe dyspnea – Diffuse bilateral infiltrates 08/12/14 LBS Pathophysiology • Injury to lungs (Scoring) – – – Abnormal gas exchange Intrapulmonary shunting Reduced lung compliance • 08/12/14 Decreased surfactant activity Amt of Infiltrates on CXR Degree of Hypoxemia Amount of PEEP Static Lung Compliance LBS Pathophysiology • Physiologic alterations – Injury to pulmonary endothelium and alveolar epithelium causes increase in lung permeability – Fluid leaks into interstitial spaces causing pulmonary edema – INCIDENCE AND PREVALENCE 08/12/14 LBS Pathophysiology • Physiologic alterations – Injury to Type II pneumocytes, causes increase in surface tension and atelectasis – Alveolar-capillary membrane damage, inflammation occurs, substances gather at site of injury decreasing gas exchange 08/12/14 LBS Pathophysiology • American-European Consensus Conference (1994) Defines ARDS as: PaO2/FiO2