[JohnW]

One of my friends recent grad school interviews began with the questions: explain ARDS? What is thought to cause it, how is it treated? They were looking for a short and to the point answer. How would you guys have responded?

[platon20]

Originally Posted by JohnW

One of my friends recent grad school interviews began with the questions: explain ARDS? What is thought to cause it, how is it treated? They were looking for a short and to the point answer. How would you guys have responded?

Series of immunologic reactions to various lung insults, among them being trauma, infection, burn. The most prominent inflammatory reaction is pulmonary edema. It has to be acute onset, bilateral, PaO2/FiO2 < 200, and pulm artery wedge pressure < 18.

Treatment consists supportive measures while you try to find and treat the underlying cause. Broad spectrum IV antibiotics are almost always started. Ventilation, diuresis, medium dose steroids, and nitric oxide are mainstays of supportive care.

[JohnW]

Originally Posted by platon20

Series of immunologic reactions to various lung insults, among them being trauma, infection, burn. The most prominent inflammatory reaction is pulmonary edema. It has to be acute onset, bilateral, PaO2/FiO2 < 200, and pulm artery wedge pressure < 18.

Treatment consists supportive measures while you try to find and treat the underlying cause. Broad spectrum IV antibiotics are almost always started. Ventilation, diuresis, medium dose steroids, and nitric oxide are mainstays of supportive care.

Perfect, thanks!

I'm assuming the wedge is used as a differential versus CHF?

[RN1980]

well in many cases the tx for ards may have many of the same tx modalities that chf has, such as diuretic, vent support in which alot of times chf will respond with the use of peep and it's a mainstay for the tx of ards. as far as the wedge, it's possible that the wedge and pa readings will be close to the same with ards and chf. we primarly dx it by cxr.

[lorilou22RN]

We have been proning patients who do not respond with other modalities. Some success yet, typically last ditch

[NewTravie]

Short and to the point ARDS is non-cardiogenic pulmonary edema caused by some sort of trauma. Mechanically ventilate, settings depending on what pt requires. Corticosteroids, diuretics, treat VAP if that occurs, treat sepsis if that occurs. I have seen jet ventilation help in really bad cases.