ARDS adult resp distress syndrome

  1. Hi everyone.....I have a question. Have any of you ever had patients develop ARDS (as in aspirative pneumonia) after routine surgery? I developed this after surgery to install ORFE (I thnk thats the name? metal hardware in my leg) Anyway I ended up with the high pressure O2 on a vent 21 days etc, the whole set of complications that goes along including renal failure etc. Anyway, that was 16 yrs ago.. Im now 34 and looking to have children, and my questtion is if I had to have anaesthesia again am I likely to have the same problem again? Should I make sure the OB has my records from the first time around assuming I can locate them? I believe in drug free low tech births but my worry is what about emergency C sections etc.

    Laura
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  2. 3 Comments

  3. by   loisane
    Laura,

    ARDS is a syndrome associated with trauma, sepsis, multiple organ failure, etc. It is also known as non-cardiogenic pulmonary edema. Protein rich fluid collects in the lung alveoli, making oxygenation poor. Patients require high levels of oxygen and PEEP to keep adequate oxygen levels.

    In my experience, ARDS is difficult to survive. But if you were the young, healthy victim of a trauma (that caused your fracture?), then I suppose that would explain it.

    If it was ARDS, I don't think that had anything (directly) to do with the anesthetic, and hence your risk of getting it again is no higher than any other person. Perhaps someone with more recent ICU experience might be able to be more specific.

    However, you also mention aspiration pneumonia. If that was the cause of your respiratory failure, then I would be a bit more concerned. You probably had a general anesthetic for ORIF (open reduction internal fixation, in English-setting a broken bone). During induction of anesthesia it is possible for stomach contents to enter the airway structures. If this aspiration is bad enough it can do widespread damage to the lungs, and cause significant problems with oxygenation.

    If aspiration was the cause of your respiratory failure, then it would be helpful to examine your anesthesia record. Maybe you were at risk for aspiration because the surgery was emergency, and you weren't NPO.

    Most importantly, did the anesthesia provider have trouble getting the endotracheal tube in place? If this is the case, then you are a "difficult intubation" . This is important information for you to relay to your anesthesia provider anytime you have anesthesia. It is only a problem if it is unanticipated. With advance warning, it can be managed fine.

    Hope this helps. Good luck with starting your family.

    loisane crna
  4. by   lml33
    How long were you NPO proir to surgery? I'm not sure what the standard protocol for those who receive general anesthesia (because I'll begin anesthesia school in Jan 2004), but inserting a naso or orogastric tube during surgery would gently remove stomach contents that may have been recently ingested. Do you have a problem with acid reflux? That may also be a contributing factor. If you aspirated gastric contents, then you could have most likely developed ARDS. Gastric contents are highly acidic. (Out of curiousity, does anyone know the exact pH?) The acid is highly caustic to the lungs. Alevoli could have been damaged, causing atelectasis. If you have a problem with reflux, or heartburn, see your physician. That should be detected early to to reduce the risk of Barrett's esophagus or esophageal cancer. It can be easily managed by Nexium or whatever is comparable to it. Let your nurse, doctor, and anesthesiologist or nurse anesthetist know what has happened in the past. Stay NPO for the designated time pre-op. I hope everything turns out okay for you! Just remember to tell all of your health practitioners what happened in the past, prior to your surgery. Preventitive measures may be taken if there are chances that it may happen again. Good luck to you! Leslie.
  5. by   obeyacts2
    I have no idea how long I was NPO, I was hit by a car while walking in a crosswalk and had surgery to repair my mangled leg. All I remember was the ER and getting Xrays......then 8 days later waking up on a vent. BTWW, we are doing digestive system in Integrative AP and the Ph for gastric juices/HCL is 2!!!!!!!! Yes I really did have ARDS. Scary stuff which I hope to never repeat.

    Laura

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