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20 Cards in this Set
- Front
- Back
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Problem List for ARDS
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aspiration
ARDS -acute onset -BL infiltrates on CXR -PaO2 to FiO2 ratio =/<300 -not due to cardiac failure or fluid overload |
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What can ARDS result from?
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direct or indirect lung injury
-pneumonia -aspiration -trauma -sepsis -acute pancreatitis |
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4 pieces of systemic inflammatory response system
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fever, tachypnea, tachycardia, leukocytosis
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Sepsis determination
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infection & > or = to 2 SIRS criteria
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Septic shock
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hypotension despite fluid resuscitation
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Purpose of basement membranes
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prevent movement of proteins (and eventually water)
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Outcomes of alveolar collapse
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V/Q mismatch or shunt
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Bottom line change in BM during ARDS
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breakdown of tight junctions, allowing protein to cross (pulm edema)
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How does edema affect surfactant?
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Dec function, causing atelectasis
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Time table for edema in ARDS
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first day or so
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When are hyaline membranes laid down in ARDS?
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2-7 days
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When does proliferative phase occur in ARDS?
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>1 week, fibrosis
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What collagen is laid down during ARDS?
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Type I and III collagen
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What main PFT will be affected in ARDS?
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dec DLCO
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Underlying cause of Ventilator-induced lung injury
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too much volume
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spectrum of extremes with ventilation
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risk of overdistension
risk of atelectasis (collapse) |
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What is PaO2:FiO2 ratio used for in ARDS?
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severity of ARDS
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predictors of poor outcomes
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age (older worse)
etiology (sepsis worst) |
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Morbidity of ARDS
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persistent abnormal exercise endurance
impared LF neuro impairment depression memories of critical care |
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2 main results of ICU acquired weakness
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critical illness polyneuropathy
critical illness myopathy Role for immediate physical rehab |
