Acute respiratory distress syndrome

1. Dr. Deepak M. Kokane
Associate Professor, Dept. of Anaesthesiology,
VDGIMS, Latur

6. Acute Respiratory Distress Syndrome
 Def. - ARDS is a clinical syndrome of
severe dyspnea of rapid onset,
hypoxaemia & diffuse pulmonary
infiltrates leading to respiratory failure.
 ARDS is caused by the diffuse lung injury
from many underlying medical or surgical
conditions.
 The lung injury – Direct ( e.g. Toxic gas
inhalation)

7. Direct Lung Injury Indirect Lung Injury
Pneumonia Sepsis
Aspiration of gastric contents Severe trauma
• Multiple rib fractures
• Flail chest
• Head Injury
• Severe burns
Pulmonary contusion
Near Drowning *
Toxic Gas Inhalation *
MultipleTransfusions
Drug Overdose
Pancreatitis
Post Cardio-pulmonary bypass

10. Early signs/symptoms
 Restlessness
 Dyspnoea
 Hypotension
 Confusion
 Extreme tiredness
 Disorientation
 Cough
 Fever

11. Late signs/symptoms
 Severe difficulty in breathing – laboured,
rapid
 Shortness of breath
 Tachycardia
 Cyanosis
 Thick Frothy sputum
 Metabolic acidosis
 Crackles
 ↓ PaO2

12.  History
 Physical Exam. – Abnormal breath sounds
 Investigations –
ABG
Chest X ray
Bronchoscopy
Sputum cultures
Chest CT
Echocardiography

13.  Hospitalization & ICU management
 No specific therapy
 Supportive measures
Supplemental O2
Mechanical Ventilation
Position strategy – Supine to prone
 Fluid Therapy
 Antibiotics
 Corticosteroids
 Diuretics
 Ionotropes