Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
ARDS
|
rapid progressing, fulminating form of hypoxemic respiratory failure, often occurs in previously health persons who have sustained severe physciological insult
48-96 hours after event high mortality rate |
|
causes of ARDs
|
direct - pulmonary insults - pneumonia, aspiration, fat/air embolus, lung contusion, tuberculosis, inhaled toxins, chest trauma
indirect Isystemic)- shock, sepsis, pancreatitis, uremia, drug overdose, trauma, DIC, massive transfusion reactions |
|
ARDS pathophys
|
acute lung injury - inflammatory/immune response - release of cellular mediators
|
|
stages of ARDS
|
injury/exudative statge
reparative/proliferative stage fibrotic stage |
|
injury/exudative stage
|
1) damage to pulmonary capillaries - increased permeabililty - fluids & proteins move into alveolar spaces (decreased compliance/hypoxia)
2) decreased surfactant production - alveoli collapse - atelectasis & decreased compliance 3) hyaline lines alveolar membrane - begins fibrosis formation - diffusion impairment begins and lungs are stiff, noncompliant |
|
reparative/proliferative phase
|
lung tissue regenerates - dense fibrous tissue
alveolar membrane thickens (diffusion limited) |
|
fibrotic phase
|
lungs completely remodeled - fibrous tissue is not compliant
|
|
ARDS clinical manifestations
|
tachypnea/dyspnea - accessory muscles
adventitous lung sounds (diffuse crackles) refractory hypoxemia - hallmark sign ABGs - o2 does not increase with therapy cyanosis- late sign CV sx |
|
ventilator association pneumonia
|
good infection control to prevent
ventilator bundle protocol (elevated HOB, sedation vacation, peptic ulcer prophylaxis, venous thrombosis phrophylaxis) |
|
barotrauma
|
overdistended alveoli rupture during mechanical ventilation (permissive hypercapnia - ventiilator with smaller tidal volume)
|
|
volutrauma
|
alveolar function - fluid and trauma in alveolar space
so vent with smaller tidal volume (permissive hypercapnia) or decrease PPV |
|
stress ulcer
|
correct hypotension, shock, acidosids
give H2 receptro antagnosits, P pump inhibitor, carafate |
|
refractory hypoxemia
|
hallmark sign - cannot get PaO2 up despite high flow oxygen therapy
|