Acute Respiratory Distress Syndrome (ARDS) and Acute Respiratory Failure (ARF)

Acute Respiratory Distress Syndrome (ARDS)

Definition: Respiratory failure due to non-cardiac pulmonary edema.
Causes: Direct or indirect lung injury leading to systemic inflammation, increased alveolar permeability, and fluid accumulation.
Risk Factors:
- Sepsis
- Shock
- Trauma
- Pneumonia
- Pancreatitis
- Inhalation of chemicals or water (e.g., near drowning)
Symptoms:
- Dyspnea
- Rapid, shallow breathing
- Substernal retractions
- Tachycardia
- Cyanosis or pallor
- Crackles in lungs (due to fluid)
Diagnosis:
- ABGs
- Chest X-Ray (showing bilateral infiltrates)
Treatment:
- Correcting the underlying cause
- Oxygen administration
- Possible mechanical ventilation
Nursing Care:
- Maintain a patent airway
- Monitor cardiac status
- Provide mechanical ventilation care

Definition: Inability of the lungs to maintain arterial oxygenation or eliminate carbon dioxide, leading to tissue hypoxia.
Risk Factors:
- Atelectasis
- COPD
- Cystic fibrosis
- Heart failure
- Pneumonia
- Pneumothorax
- Pulmonary embolism
Symptoms:
- Respiratory distress
- Tachycardia
- Dysrhythmia
- Signs of hypoxia (e.g., restlessness, decreased level of consciousness)
Treatment:
- Oxygen therapy
- Mechanical ventilation
- Chest physiotherapy
- BiPAP/CPAP
- Medications (bronchodilators, corticosteroids, antibiotics, inotropic agents like digoxin, vasopressors, diuretics)
Nursing Care:
- Maintain a patent airway
- Effective patient positioning (elevate head of bed at least 30 degrees, "good lung" down, prone position)
- Encourage coughing and deep breathing for non-intubated patients
- Increase fluid intake
- Monitor ABGs, eyes & nose, fluid & electrolytes, and cardiac status