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Respiratory Distress Syndrome, Acute (ARDS)

Ahmed Munir, MBBS, Carrie Valenta, MD and Robert Plambeck, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Acute respiratory distress syndrome is defined as onset of acute hypoxemia within 7 days of known clinical insult or new or worsening respiratory symptoms. On imaging, it appears as ...

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 the cause of ARDS and treat the cause.

  • Central venous line and arterial line insertion

  • Ventilatory support generally requires endotracheal intubation and use of PEEP w...

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 Acute Respiratory Distress Syndrome Clinical Trials Network. Comparison of two fluid-management strategies in acute lung injury. N Engl J M...

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. [View Abstract on OvidMedline]

  • Matthay MA, McAuley DF, War...

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 onset of hypoxemia secondary to an injury to the lung which appears as bilateral infiltrates on imaging and divided in severity with measurement of PaO2/FiO2.

  • Treatment is treat...

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