Discuss common risk factors and therapeutic interventions for ALI and ARDS
List and describe the clinical and radiographic findings that are associated with ALI and ARDS
Discuss the pathophysiology of ALI and ARDS
Describe the therapeutic treatment and interventions for ALI and ARDS.
Acute respiratory distress syndrome (ARDS) occurs secondary to a catastrophic illness and is a syndrome and not a specific disease. It is unknown at this time which injuries place an individual at risk for developing ARDS. Patients with acute lung injury and acute respiratory distress syndrome are among the sickest respiratory patients. The goal of treatment and management for these patients are as follows and is critical to their survival and recovery:
Identify and treat the underlying injury
Improve gas exchange
Ensure adequate oxygen delivery to the tissues
Prevent further lung injury
Acute lung injury (ALI) is usually classified by a PaO2/FiO2 ratio (PF ratio) of less than 300 mmHg and ARDS is usually classified by a PF ratio of less than 200 mmHg. The PaO2/FiO2 ratio is the ratio of arterial oxygen partial pressure to fractional inspired oxygen and is a widely used clinical indicator of hypoxemia. It is used to quickly provide an estimate to whether there is a significant A-a gradient present. The lower the value of the PF ratio indicates a widened A-a gradient which is an indication of severely poor oxygenation.
The onset of symptoms are acute for both ALI and ARDS and the symptoms are severe. Patients with ALI and ARDS will require a multidisciplinary approach to the management of their condition. Care for these patients include oxygen therapy; mechanical ventilation; medications to treat infections and prevent blood clots along with other supportive care; nutritional support, adequate hydration; and lung recruitment maneuvers to treat atelectasis.
In order for patients with ALI/ARDS to maintain adequate gas exchange they will require mechanical ventilion.The ARDSNet study makes recommendations for the management of ALI/ARDS receiving mechanical ventilation. Please review recommendations from the ARDSNet by following the link below.
NHLBI ARDS Network http://www.ardsnet.org/ (Links to an external site.)
ARDSNet Protocol http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf (Links to an external site.)
Provide detailed responses to the following:
Respiratory failure is classified as Type I and Type II respiratory failure. Describe each and explain whether ALI/ARDS is classified as a Type I or II failure.
According to the ARDS Network what is the treatment of ARDS? What is the estimated time for healing?
According to the ARDSNet protocol what are some of the recommendations for the management of patient’s with ALI/ARDS receiving mechanical ventilation?
Submit your answers in at least 500 words on a Word document. You must cite at least three references in APA format to defend and support your position.