Acute respiratory distress syndrome is an acute, life-threatening condition of inflammatory origin in which accumulation of fluid and other changes in the lungs result in severely impaired oxygenation of the blood, typically requiring treatment by mechanical ventilation
2. .ARDS is the clinical
syndrome which is
characterized by a sudden
and progressive pulmonary
edema, increased bilateral
infiltrates on chest X-ray,,
reduced lung compliance
and hypoxemia refractory to
oxygen Supplementation
6. ETIOLOGY
.Aspiration (gastric secretion, drowning)
.Drug ingestion and overdose
.Hematological disorder
.Prolonged inhalation of high concentrations
of oxygen, smoke and corrosive substance
.Major surgery
.Fat embolism
.systemic sepsis Shock, trauma
7. Clinical manifestation
ARDS is an acute event that typically develops over
4 to 48 hours. The acute phase of ARDS is marked
by a rapid onset of severe dyspnea that usually
occurs 12 to 48 hours after initiating the event.
Other signs and symptoms include:
.Increased pulse rates
.Low PaO
.Dyspnea
.Marked restlessness
9. Diagnosis
. physical examination, intercostal retraction
and crackles may be present as the fluid
begins to leak into the alveolar interstitial
space. Common diagnostic tests performed in
patient with potential ARDS include
11. Management
-The primary focus in the management of ARDS includes
identification and treatment of the underlying condition.
-The supportive therapy almost always includes intubation
and mechanical ventilation.
- Supplement oxygen is used by the patient to begin the
initial spiral of hypoxemia. As the hypoxemia progresses
intubation and mechanical ventilation are required.
12. -In addition, circulatory support, adequate fluid
volume, and nutrition support are important.
-Intravenous fluids are given to provide
nutrition and prevent dehydration and are
Carefully monitored to prevent fluid from
accumulating in lungs
13. -Antibiotic therapy is provided for
infection
-Antianxiety to reduce the anxiety
-Diuretics to eliminate fluid from lungs
-Anti inflammatory drugs
14. Adequate nutritional therapy support is vital in
the treatment of ARDS. Patients with ARDS
require 35 to 45 kcal/kg/day to meet caloric
requirements.
Enteral feeding is the first consideration;
however, parental nutrition may also be
required
15. Nursing management
1) Assessment
.Assess breathing sound
.Assess sign of hypoxemia and hypercapnea
.Note the changes suggesting increased work of
breathing or pulmonary
.Determine hemodynamic status and compare it with
previous value
.Analyze the ABG and compare the previous values
16. 2) Diagnoses
. Impairrd gas exchange related to
congestion
. Acute pain related to inflammatory
process and dyspnea
. Anxiety related to fear of death
17. 3) Nursing interventions
_promoting adequate ventilation
.Facilitate respiratory management; position patient to
maximize respiration, oxygen, endotracheal intubation,
tracheostomy, suctioning, and mechanical ventilation with
sedation and paralytics as needed
• Chest physiotherapy (monitor closely for deterioration in
oxygenation with changes in position)
• Provide safety interventions related to ventilator care
• Encourage rest to limit oxygen consumption • .Encourage
oral fluid intake if patient is not ventilated
18. _Relieving pain:
.Watch patient for sign of discomfort
and pain
.Position the head elevated
Give prescribed morphine and
monitor for pain-relieving sign
19. _Reducing anxiety:
. Correct dyspnea and relive physical
discomfort
.speak calmly and slowly
.Explain diagnostic procedure
.Listen to the patient
