Adult Respiratory Distress Syndrome (ARDS)

Pathology:                   Acuterespiratory failure with oedematous lung field resulting from inflammatoryevents without a raised left atrial pressure

The oedema arises due to increased alveolar permeability

Aetiology:                     Pulmonary Insult

Pneumonia

Aspiration

Inhalationinjury (e.g. smoke)

Lungcontusion

Non-Pulmonary Insult

Sepsis

Trauma

Burns

Pancreatitis

Symptoms:                   Shortnessof breath, agitation

Signs:                               Tachypnoea,confusion secondary to hypoxia

Investigations:          Chest X-Ray: Bilateral infiltrates

ABG: PaO₂/FiO₂ < 26.7 kPa(<200 mmHg)

Pulmonary Artery Wedge Pressure: <18mmHg

Treatment:                  Theunderlying cause must be treated if possible. Good supportive care is key

Complications:          Prolongedperiod of mechanical ventilation

Prognosis:                  Mortalityrate 50-60%

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Figure 2.8 Chest X-raydemonstrating ARDS

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