Hello Students, I am discussing in this video tutorial about ARDS or Acute Respiratory distress syndrome for PG Medical Entrance Exams and USMLE preparation. If you want to cover this topic for MCQ type exams, you must first listen to tutorial and then read these points and then if you study the topic from some standard textbook of Medicine, you will find it very interesting and easy to understand.
ARDS is characterized by
Breathlessness, Decreased PO2 — Hypoxaemia and Diffuse pulmonary infiltrates
We can also found Low Tidal Volume and non cardiogenic Pulmonary edema in ARDS.
In addition, Acute respiratory distress syndrome is also characterized by Increase in Respiratory rate and leading to CO2 washout and resulting in hypocapnea. ARDS can lead to Stiff lung with reduced compliance
Etiology: ARDS has varied etiology and following points must be remembered as etiological factors for ARDS
Sepsis and Multiorgan Failure
Multiple blood transfusions
Toxic gas inhalation
Phases: ARDS has following 3 phases.
Exudative Phase- Edema-7 days
Proliferative phase- Interstitial inflammation-8-21 days
Fibrotic phase- Fibrosis-After 3 weeks
ARDS: PaO2/FIO2 <200 mmHg
ALI : PaO2/FIO2 200-300 mmHg
Bilateral alveolar or interstitial infiltrates
PCWP <18 mmHg
Treatment of underlying medical condition
Hydration and Nutrition
Low Tidal volume mechanical ventilation, Prone positioning, minimize left atrial filing pressures
No definitive role of glucocorticoids