�ݺ�ߣ

1
ACUTE RESPIRATORY
DISTRESS SYNDROME
(ARDS)
Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli

2
INTRODUCTION TO RESPIRATORY SYSTEM

3
contd…………

4
contd…………

5
contd…………

6
RESPIRATORY DISTRESS SYNDROME (ARDS)
• Acute respiratory distress syndrome (ARDS) is a life-threatening
lung condition that prevents enough oxygen from getting into the
blood.
• Acute respiratory distress syndrome was first described in 1967 by
Ashbaugh and colleagues.
• ARDS is also referred with variety of terms like
• Stiff Lung
• Shock lung
• Wet lung
• Post traumatic lung
• Adult respiratory distress syndrome
• Adult hyaline membrane disease
• Capillary leak syndrome &
• Congestive atelectasis.

7
DEFINITION
• Acute respiratory distress syndrome (ARDS) is a
sudden and progressive form of acute
respiratory failure in which the alveolar
capillary membrane becomes damaged and
more permeable to intravascular fluid resulting
in severe dyspnea, hypoxemia and diffuse
pulmonary infiltrates.

Mr sanjay. M. Peerapur, Principal, KLES Insti
tute of Nursing Sciences, Hubli
8
STAGES OF ODEMA FORMATION IN ACUTE
RESPIRATORY DISTRESS SYNDROME

9
ETIOLOGY & RISK FACTORS
• Direct Lung Injury
– Common causes
• Aspiration of gastric contents or other substances.
• Viral/bacterial pneumonia
– Less Common causes
• Chest trauma
• Embolism: fat, air, amniotic fluid
• Inhalation of toxic substances
• Near-drowning
• O2 toxicity
• Radiation pneumonitis

10
ETIOLOGY & RISK FACTORS contd…….
• Indirect Lung Injury
– Common causes
• Sepsis
• Severe traumatic injury
– Less common causes
• Acute pancreatitis
• Anaphylaxis
• Prolonged Cardiopulmonary bypass surgery
• Disseminated intravascular coagulation
• Multiple blood transfusions
• Narcotic drug overdose (e.g., heroin)
• Nonpulmonary systemic diseases
• Severe head injury
• Shock
• Massive blood transfusion.

11
SCHEMATIC REPRESENTATION OF PATHOPHYSIOLOGY OF ARDS
Lung injury
Release of Vasoactive substances
(serotonin, histamine,
bradykinin)
Damaged Type II alveolar cell
Surfactant production
Alveolocapillary
membrane
permeability
Vascular
narrowing &
obstruction
Alveolar
Compliance and recoil
Bronchoconstriction
Outward migration
of blood cells &
fluids from
capillaries
Atelectasis
Pulmonary Edema
Hyaline membrane
formation
Lung
compliance
Impairment in
gas exchange
ARDS
Pulmonary
hypertension

12
CLINICAL MANIFESTATIONS
• Early signs/symptoms
– Restlessness
– Dyspnea
– Low blood pressure
– Confusion
– Extreme tiredness
– Change in patient’s behavior
• Mood swing
• Disorientation
• Change in LOC
– If pneumonia is causing ARDS then client may have
• Cough
• Fever

13
CLINICAL MANIFESTATIONS CONTD…………
Late signs & symptoms
– Severe difficulty in breathing i.e., labored, rapid
breathing.
– Shortness of breath.
– Tachycardia
– Cyanosis (blue skin, lips and nails)
– Think frothy sputum
– Metabolic acidosis
– Abnormal breath sounds, like crackles
– PaCo2 with respiratory alkalosis.
– PaO2

14
DIAGNOSITC EVALUATION
• History of above symptoms
• On physical examination
– Auscultation reveals abnormal breath sounds
• The first tests done are :
– Arterial blood gas analysis
– Bood tests
– Chest x-ray
– Bronchoscopy
– Sputum cultures and analysis
• Other tests are :
– Chest CT Scan
– Echocardiogram

15
COMPLICATIONS
• Common complications are;
– Nosocomial pneumonia:
– Barotrauma
– Renal failure
• Other complications are :
– O2 toxicity,
– stress ulcers,
– Tracheal ulceration,
– Blood clots leading to deep vein thrombosis &
– pulmonary embolism.

16
MEDICAL MANAGEMENT
• Persons with ARDS are hospitalized and require
treatment in an intensive care unit.
• No specific therapy for ARDS exists.
• Supportive measures :
– Supplemental oxygen
– Mechanical respirator
– Positioning strategies
• Turn the patient from supine to prone.
• Another position is lateral rotation therapy
• Fluid therapy

17
TURNING PATIENT PRONE ON VOLLMAN PRONE POSITIONER

18
PATIENT LYING PRONE ON VOLLMAN PRONE POSITIONER

19
LATERAL ROTATION THERAPY BED

20
MEDICAL MANAGEMENT contd…….
• Medications :
– Antibiotics
– Anti-inflammatory drugs; such as corticosteroids
– Diuretics
– Drugs to raise blood pressure
– Anti-anxiety
– Muscle relaxers
– Inhaled drugs (Bronchodilators)

21
NURSING DIAGNOSIS
1. Ineffective breathing pattern related to decreased lung
compliance, decreased energy as characterized by
dyspnea, abnormal ABGs, cyanoisis & use of accessory
muscles.
2. Impaired gas exchange related to diffusion defect as
characterized by hypoxia (restlessness, irritability & fear of
suffocation), hypercapnia, tachycardia & cyanosis.
3. Risk for decreased Cardiac output related to positive
pressure ventilation
4. Ineffective protection related to positive pressure
ventilation, decreased pulmonary compliance & increased
secretions as characterized by crepitus, altered chest
excursion, abnormal ABGs & restlessness.

NURSING DIAGNOSIS CONTD……..
5. Impaired physical mobility related to monitoring
devices, mechanical ventilation & medications as
characterized by imposed restrictions of movement,
decreased muscle strength & limited range of
motion.
6. Risk for impaired skin integrity related to prolonged
bed rest, prolonged intubation & immobility.
7. Knowledge deficit related to health condition, new
equipment & hospitalization as characterized by
increased frequency of questions posed by patient
and significant others.
Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli 22

�ݺ�ߣ

ARDS PPT EXPLANATION.pptx explanation in

Recommended

More Related Content

Similar to ARDS PPT EXPLANATION.pptx explanation in (20)

More from Soum Geo (20)

Recently uploaded (20)

ARDS PPT EXPLANATION.pptx explanation in