Lecture Notes: Acute Respiratory Distress Syndrome (ARDS) and Acute Respiratory Failure (ARF)
Acute Respiratory Distress Syndrome (ARDS)
Definition
- ARDS is respiratory failure due to non-cardiac pulmonary edema.
- Unlike pulmonary edema from left-sided heart failure, ARDS involves lung injury that leads to fluid accumulation in the alveoli.
Causes
- Direct or indirect lung injury causing systemic inflammation.
- Increased alveolar permeability allows fluid collection in lungs.
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 lung sounds
Diagnosis
- ABGs (Arterial Blood Gases)
- Chest X-ray showing bilateral infiltrates
Treatment
- Correct underlying cause
- Oxygen therapy
- Mechanical ventilation may be necessary
Nursing Care
- Maintain a patent airway
- Monitor cardiac status
- Provide mechanical ventilation care
Acute Respiratory Failure (ARF)
Definition
- Inability of lungs to maintain arterial oxygenation or eliminate carbon dioxide, leading to tissue hypoxia.
Risk Factors
- Atelectasis
- COPD (Chronic Obstructive Pulmonary Disease)
- 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 (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)
- Medications: bronchodilators, corticosteroids, antibiotics, inotropic agents (e.g., digoxin), vasopressors, diuretics
Nursing Care
- Maintain a patent airway
- Promote effective positioning (head of bed ≥ 30 degrees)
- Consider prone positioning for better oxygenation
- Encourage coughing, deep breathing, and increased fluid intake for non-intubated patients
- Monitor ABGs, fluid and electrolytes, and cardiac status
Conclusion
- Next video topic: Mechanical ventilation for ARDS and ARF treatment.
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Remember to review the nursing care and treatment options, as they are critical for patient management in both ARDS and ARF. Keep an eye out for symptoms and risk factors to promptly identify and treat these respiratory conditions.