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Respiratory Distress Syndrome, Acute (ARDS)

Ashley Twyman, MD and Clayton Smith, MD, FACP Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Acute respiratory distress syndrome (ARDS) is defined as the onset of acute hypoxemia within 7 days of a known clinical insult or new or worsening respiratory symptoms with bilateral...

DIAGNOSIS

HISTORY

Precipitating event (see “Etiology and Pathophysiology”) followed by abrupt onset of respiratory distress 

PHYSICAL EXAM

  • Tachypnea and tachycardia during the first 12 to 24 hours; incre...

TREATMENT

GENERAL MEASURES

  • Identify and treat the cause of ARDS.

  • Central venous line and arterial line insertion

  • Ventilatory support generally requires endotracheal intubation and use of PEEP with lung p...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Driving pressure and static lung compliance are important measures of lung mechanics.

  • Daily labs are needed until the patient is no longer critic...

REFERENCES

1
Wiedemann HP, Wheeler AP, Bernard GR, et al; for The National Heart, Lung, Blood Institute Acute Respiratory Distress Syndrome Clinical Trials Network. Comparison of two fluid-management s...

ADDITIONAL READING

  • Chiumello D, Coppola S, Froio S, et al. What’s next after ARDS: long-term outcomes. Respir Care.  2016;61(5):689–699.

  • Matthay MA, McAuley DF, Ware LB. Clinical trials in acute r...

CODES

ICD10

J80 Acute respiratory distress syndrome 

ICD9

518.52 Other pulmonary insufficiency, not elsewhere classified, following trauma and surgery 

SNOMED

67782005 Adult respiratory distress syndrome (...

CLINICAL PEARLS

  • ARDS is the acute onset of hypoxemia secondary to alveolar injury with a PaO2/FiO2 ≤300 mm Hg and bilateral infiltrates on chest x-ray.

  • Identify and treat the underlying cause along wit...

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