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Pulm Disease Exam 3
SPC Pulmonary Disease Exam 3 Ch. 28 ARDS
Question | Answer |
---|---|
The major pathological changes associated with ARDS are? | 1. Interstitial & Intraalveolar Edema & Hemorrhage 2. Alveolar Consolidation 3. Intraalveolar Hyaline membrane formation 4. Pulmonary surfactant deficiency 5. Atalectasis |
Berlin definition of ARDS? | 1. Symptoms manifested within 1 week 2. Bilateral opacities apear on radiograph 3. Failure cannot be explained by heart failure or fluid overload 4. Moderate-Severe impairment of oxygenation must be present |
Causes of ARDS? | 1. Sepsis 2. Aspiration 3. Pneumonia 4. Severe Trauma 5. Massive Blood Transfusion |
Clinical data obtained vital signs of ARDS? | 1. Tachypnea 2. Refractory Hypoxemia 3. ^HR & ^BP 4. Substernal Intercostal Retractions 5. Cyanosis |
Chest Assessment Findings of ARDS? | 1. Dull percussion notes 2. Bronchial breath sounds 3. Crackles |
Radiologic Findings of ARDS? | Bilateral alveolar "fluffy" infiltrates |
what you expect to see with severe ARDS? | Lungs become denser & whiter w/ ground-glass appearance |
Barotrauma with ARDS? | On mechanical vent ARDS is susceptible to barotrauma (keep plateau >30cmH2O |
What is barotrauma or volutrauma? | Overexpansion of alveoli, tearing or popping |
3 ARDS treatment protocols? | 1. O2 Therapy "Hypoxemia" 2. Lung Expansion Therapy "PEEP" 3. Mechanical Vent "Gas Exchange" |
The recommended ventilation therapy for ARDS? | Low Tidal Volume Ventilation & High Respiratory Rate |
With ARDS, PEEP is recommended when what? | PaO2/FIO2 is <200mmHg |
With ARDS the patients PaCO2 is often allow to increase to? | Permissive Hypercapnia as a trade off to protect lungs from high airway pressures. |
A higher PaCO2 should not allow? | Severe Acidosis pH <7.2 |