Acute Respiratory Distress Syndrome for PG Medical Entrance Exams and USMLE

Here I will be discussing this topic with you which is very important from PG Medical Entrance Exams point of view.

Introduction:

ARDS is characterised by

—Breathlessness
—Decreased PO2 — Hypoxaemia
—Diffuse pulmonary infiltrates
Etiology: 
—Sepsis and Multiorgan Failure
—Pneumonia
—Trauma
—Drowning
—Multiple blood transfusions
—Gastric aspiration

Phases: 

3 phases

Exudative Phase- Edema-7 days

Proliferative phase- Interstitial inflammation-8-21 days

Fibrotic phase- Fibrosis-After 3 weeks

Diagnosis:

—ARDS: PaO2/FIO2 <200 mmHg
—ALI    : PaO2/FIO2  200-300 mmHg
—Bilateral alveolar or interstitial infiltrates

PCWP <18 mmHg

Treatment: 

—Treatment of underlying medical condition
—DVT prophylaxis
—Infection control
—Hydration and Nutrition
—Low Tidal volume mechanical ventilation, Prone positioning, minimize left atrial filing pressures
—No definitive role of glucocorticoids

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