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Pulm Disease Exam 3

SPC Pulmonary Disease Exam 3 Ch. 28 ARDS

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
Created by: Langhout1418