-
type of pulm edema seen in ARDS
non-cardiogenic
-
is non-cardiogenic cause by heart failure
is not
-
in ards, lung compliance inc/dec
decrease
-
dec compliance causes lungs to become more
stiff
-
why lung compliance changes in ARDS (3)
inc in alveolar-cap permeability causes a dec in surfactant causing alveolar collapse (atelectasis)
hyaline membrane formation
alveolar consolidation
-
hypoxemia that responds poorly to supplemental oxygen administration is termed:
refractory hypoxemia
-
treatment for ARDS
- treatment of precipitative problem
- provide adequate tissue oxygenation
- provide adequate nutritional oxygenation
-
PCWP in ARDS will most likely be
normal
-
static compliance provides info about the
stiffness of the lungs and chest wall
-
static comp values are often as low as
15-20
-
increase ppl, static compliance =
decreases
-
relationship btwn ppl pressure and static lung comp is
inverse
-
ratio of carbon dioxide to oxygen consumed is termed
respiratory quotient
-
what makes RQ high
carbohydrates
-
what makes RQ low
fats and proteins
-
what RQ is more ideal for ARDS pt?
low RQ
-
most common etiologic factor associated with the development of ARDS
sepsis
-
ppl pressure should be monitored in an attempt to keep the value less than
30
-
ppl pressure less than 30 helps by reducing the risk of
barotrauma
-
mech ventilation strategies in ards includes
- pressure control mode
- inverse i:e ratio
- high rr, low vt
-
goal of this strategy is to dec high airway pressures, reduce over distension of the lungs, and dec rish of barotrauma
pressure control mode
-
used in conjuction w/ pressure control to allow more time for inspiration thereby increasin alveolar contact time w/ oxygen
inverse i:e ratio
-
decrease high airway pressures, reduce overdistension of the lungs, and decrease risk of barotrauma while maintaining adequate min vent
high rr, low vt
-
level of peep at which oxygenation improves w/out compromising cardiac output
optimal peep
-
level of peep in which a pa02 of >60 is achieved on an fi02 of <60
optimal peep
-
measure of the partial pressure of oxygen in mixed venous blood and is an indication of oxygen consumption by the body is termed as
pv02
-
normal values of pv02
35-45
-
chest radiograph findings of a pt w/ ARDS (2)
- ground-glass appearance
- increased opacity
-
use of small vt or inverse i:e ratio to keep the ppl pressure less than 30 may result in hypercapnea but is acceptable to have hypercapnea as long as the pt's pH is greater than 7.20
permissive hypercapnea
|
|