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

Acute Respiratory Distress Syndrome (ARDS)

Definition

• ARDS is a type of respiratory failure due to non-cardiac pulmonary edema.
• Differs from pulmonary edema caused by left-sided heart failure.
• Results from direct or indirect lung injury leading to systemic inflammation.

Pathophysiology

• Inflammation increases alveoli permeability, allowing fluid to enter and collect in the lungs.

Risk Factors

• Sepsis
• Shock
• Trauma
• Pneumonia
• Pancreatitis
• Inhalation of chemicals or water (near-drowning)

Signs and Symptoms

• Dyspnea
• Rapid and shallow breathing
• Substernal retractions
• Tachycardia
• Cyanosis or pallor
• Lung crackles due to fluid

Diagnosis

• Arterial Blood Gases (ABGs)
• Chest x-ray showing bilateral infiltrates

Treatment

• Correct underlying cause
• Oxygen administration
• Possible mechanical ventilation

Nursing Care

• Maintain patent airway
• Monitor cardiac status
• Provide mechanical ventilation care

Acute Respiratory Failure (ARF)

Definition

• Inability of the lungs to maintain arterial oxygenation or eliminate carbon dioxide.
• Leads to tissue hypoxia.

Risk Factors

• Atelectasis
• Chronic Obstructive Pulmonary Disease (COPD)
• Cystic Fibrosis
• Heart Failure
• Pneumonia
• Pneumothorax
• Pulmonary Embolism

Signs and Symptoms

• Respiratory distress
• Tachycardia
• Dysrhythmias
• Hypoxia symptoms (early: restlessness, late: decreased consciousness)

Treatment

• Oxygen therapy
• Mechanical ventilation
• Chest physiotherapy
• BiPAP and CPAP

Medications

• Bronchodilators
• Corticosteroids
• Antibiotics
• Inotropic agents (e.g., digoxin)
• Vasopressors
• Diuretics

Nursing Care

• Maintain patent airway
• Effective positioning (elevate head of the bed, good lung down if needed)
• Prone positioning can be beneficial
• Encourage coughing, deep breathing, and fluid intake
• Monitor ABGs, fluid and electrolytes, cardiac status

Next Steps

• Upcoming topic: Mechanical ventilation
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