Acute Respiratory Failure in Adult.pptx
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Transcript of Acute Respiratory Failure in Adult.pptx
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Acute Respiratory Failure inAdult
(Respiratory Distress Syndrome)
Marion SorianoFatima Love Ariate
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Initially called the adult respiratory distress syndrome, it
is now called the acute respiratory distress syndrome
because it also affects children
Results from increased permeability of the alveolar
capillary membrane
clinical syndrome is characterized by: a sudden and progressive pulmonary edema increasing bilateral infiltrates on chest x-ray
hypoxemia unresponsive to oxygen supplementation regardless
of the amount of PEEP
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Causes Aspiration (gastric secretions, drowning, hydrocarbons)
Drug ingestion and overdose
Hematologic disorders (disseminated intravascular
coagu-lopathy [DIC], massive transfusions,cardiopulmonary by-pass)
Prolonged inhalation of high concentrations of oxygen,
smoke, or corrosive substances
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Causes Localized infection (bacterial, fungal, viral pneumonia)
Metabolic disorders (pancreatitis, uremia)
Shock (any cause)
Trauma (pulmonary contusion, multiple fractures, head injury)
Major surgery
Fat or air embolism
Systemic sepsis
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PATHOPHYSIOLOGY
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Modifiable-lifestyle-Diet
-Infections-Chemicals-Trauma
Non-modifiable
-Age-Gender
Lung injury
Platelet aggregation
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Platelet aggregation
Increase of capillary permeability
Release of Serotonin, Bradykinin, Histamine
Pulmonary Edema
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Damage to the Type II endothelial cells
Decrease in Surfactant production
Alveolar Collapse
Fibrosis
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Diagnostic Test
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Chest X-Ray
Can reveal which parts of your lungs have fluid in them and whether
your heart is enlarged.
Can provide detailed information about the structures within the
heart and lungs.
CT Scan
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Blood Test
Such as CBC, blood chemistry, blood cultures. These tests help find
the cause of ARDS such as an infection
This test looks at the sputum coughed up from your lungs. And can
help find the cause of an infection.
Sputum Cultures
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Arterial Blood Gas Test
This blood test shows the oxygen level in your blood. A low level of
oxygen level in the blood may be a sign of ARDS.
Because signs and symptoms of ARDS are similar to those of
certain heart problems, your doctor may recommend
Electrocardiogram This test tracks the electrical activity in your
heart.
Echocardiogram This test can reveal problems with the structures
and the function of your heart.
Heart Test
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Medication
Antibiotics Given to patients for infection. Such as pneumonia.
Steroids To reduce inflammation.
Levophed This medication is given to patient with ARDS to support
blood pressure and improve oxygenation.
Sedatives are given to keep the patient calm and help them toleratebeing on a ventilator.
Inhaled Medications
Nitric Oxide
Inhaled Nitric Oxide or INO given to improve circulation within thepulmonary system
Albuterol Inhaled medication that helps keep the airways open.
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Nursing Management
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Oxygenation
Supplemental Oxygen For milder symptoms or astemporary measure. Oxygen may be delivered through a mask that
fits tightly over your nose and mouth.
Mechanical Ventilation
Most people with ARDS will needthe help of a machine to breathe. A Mechanical Ventilator pushes
air into your lungs and forces some of the fluid out of the air sacs.
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Fluid and Electrolyte
Carefully managing the amount of intravenous fluid is crucial.
Too much fluid can hinder the lungs ability to oxygenate the
blood.
Too little fluid can make the body dehydrated , making it difficult
to send enough blood and oxygen to the organs and extremities.Adequate Nutrition
The nutritional needs of the critically ill patient with ARDS must alsobe addressed because the caloric requirement increases due to
stress, sepsis, trauma, and use of mechanical Ventilation.
If the nutritional requirements are not met, respiratory function isimpaired as result to negative nitrogen balance.
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Surgical Management