Acute Respiratory Distress Syndrome (ARDS) Questions & Answers

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Questions & Answers

Overview

What is the origin of acute respiratory distress syndrome (ARDS)?

How is acute respiratory distress syndrome (ARDS) defined?

What is the role of diffuse alveolar damage (DAD) in the pathogenesis of acute respiratory distress syndrome (ARDS)?

How is early acute respiratory distress syndrome (ARDS) characterized?

What are the injuries that result in acute respiratory distress syndrome (ARDS)?

What injuries to the alveolar epithelium result in acute respiratory distress syndrome (ARDS)?

What are characteristics of type II alveolar cells involved in the pathogenesis of acute respiratory distress syndrome (ARDS)?

What is the role of neutrophils in the pathogenesis of acute respiratory distress syndrome (ARDS)?

What is the role of the immune system in the pathogenesis of acute respiratory distress syndrome (ARDS)?

How does acute respiratory distress syndrome (ARDS) progress following injury to alveoli?

How does acute respiratory distress syndrome (ARDS) cause hypoxemia?

What is the role of pulmonary hypertension in the pathogenesis of acute respiratory distress syndrome (ARDS)?

What factors lead to mortality in acute phase of acute respiratory distress syndrome (ARDS)?

What are the common risk factors for acute respiratory distress syndrome (ARDS)?

What are the major risk factors for acute respiratory distress syndrome (ARDS)?

Which patient groups are at increased risk for the development of acute respiratory distress syndrome (ARDS)?

What are the genetic risk factors of acute respiratory distress syndrome (ARDS)?

Why is the incidence of acute respiratory distress syndrome (ARDS) difficult to quantify?

What is the incidence of acute respiratory distress syndrome (ARDS) in the US?

What is the global incidence of acute respiratory distress syndrome (ARDS)?

What are the age-related differences in incidence for acute respiratory distress syndrome (ARDS)?

How does the incidence of acute respiratory distress syndrome (ARDS) vary by sex?

What are the mortality rates for acute respiratory distress syndrome (ARDS)?

Which factors increase the mortality risk of acute respiratory distress syndrome (ARDS)?

What are the morbidities associated with acute respiratory distress syndrome (ARDS)?

What is the effect of acute respiratory distress syndrome (ARDS) on quality of life following recovery?

What are some patient education resources for acute respiratory distress syndrome (ARDS)?

Presentation

What are the signs and symptoms of acute respiratory distress syndrome (ARDS)?

Which physical findings are characteristic of acute respiratory distress syndrome (ARDS)?

Which lung exam findings are characteristic of acute respiratory distress syndrome (ARDS)?

What should be the focus of the physical exam in a septic patient with suspected acute respiratory distress syndrome (ARDS)?

How is cardiogenic pulmonary edema distinguished from acute respiratory distress syndrome (ARDS)?

What complications may occur in mechanically ventilated patients with acute respiratory distress syndrome (ARDS)?

When is a tracheostomy indicated in the management of acute respiratory distress syndrome (ARDS)?

Which nosocomial infections are patients with acute respiratory distress syndrome (ARDS) at increased risk of contracting?

Which secondary infections are common in acute respiratory distress syndrome (ARDS)?

Which treatments for acute respiratory distress syndrome (ARDS) may cause muscle weakness and poor functional recovery?

How are patients with acute respiratory distress syndrome (ARDS) weaned from mechanical ventilation?

Why is renal failure a frequent complication of acute respiratory distress syndrome (ARDS)?

What are potential complications of acute respiratory distress syndrome (ARDS)?

What are the long-term sequelae of acute respiratory distress syndrome (ARDS)?

DDX

Which medical conditions should be included in the differential diagnoses of acute respiratory distress syndrome (ARDS)?

What are the differential diagnoses for Acute Respiratory Distress Syndrome (ARDS)?

Workup

How is acute respiratory distress syndrome (ARDS) diagnosed?

What is the expected partial pressure of oxygen in the arterial blood (PaO2) in acute respiratory distress syndrome (ARDS)?

What is the role of arterial blood gases in the evaluation of acute respiratory distress syndrome (ARDS)?

What happens to the partial pressure of carbon dioxide (PCO2) as acute respiratory distress syndrome (ARDS) progresses?

How is cardiogenic pulmonary edema differentiated from acute respiratory distress syndrome (ARDS)?

Which abnormalities of acute respiratory distress syndrome (ARDS) are related to the underlying etiology?

What is the role of radiography in the evaluation of acute respiratory distress syndrome (ARDS)?

When are signs of recovery from acute respiratory distress syndrome (ARDS) seen on radiographs?

What is the role of CT scanning in the diagnosis of acute respiratory distress syndrome (ARDS)?

What is the role of echocardiography in the diagnosis of acute respiratory distress syndrome (ARDS)?

What is the role of a blood vessel catheter in the management of acute respiratory distress syndrome (ARDS)?

What is the role of pulmonary artery catheters in the diagnosis and management of acute respiratory distress syndrome (ARDS)?

What is the role of bronchoscopy in the diagnosis of acute respiratory distress syndrome (ARDS)?

Which BAL fluid finding is characteristic of acute respiratory distress syndrome (ARDS)?

How is a culture obtained for the diagnosis of acute respiratory distress syndrome (ARDS)?

What is the role of cytologic evaluation of the bronchoalveolar lavage (BAL) fluid in the diagnosis of acute respiratory distress syndrome (ARDS)?

What are the histologic changes associated with acute respiratory distress syndrome (ARDS)?

Which biopsy findings are characteristic of acute respiratory distress syndrome (ARDS)?

Which histologic findings are characteristic of the final phase of acute respiratory distress syndrome (ARDS)?

Treatment

What is the role of corticosteroids in the treatment of acute respiratory distress syndrome (ARDS)?

What are the pharmacologic therapies used for the treatment of acute respiratory distress syndrome (ARDS)?

What is the role of rescue therapies in the treatment of acute respiratory distress syndrome (ARDS)?

What is the role of inhaled nitric oxide (NO) in the treatment of acute respiratory distress syndrome (ARDS)?

How are the underlying causes of acute respiratory distress syndrome (ARDS) managed?

What is the role of mechanical ventilation in the treatment of acute respiratory distress syndrome (ARDS)?

Which complications of acute respiratory distress syndrome (ARDS) should be monitored for in the ICU?

What is the management required for patients with acute respiratory distress syndrome (ARDS) taking paralyzing agents?

What is included in the management of critically ill patients with acute respiratory distress syndrome (ARDS)?

How is initial fluid resuscitation distinguished from maintenance fluid therapy in the treatment of acute respiratory distress syndrome (ARDS)?

What are the differences in efficacy between fluid-conservative strategies and the fluid-liberal strategies for the treatment of acute respiratory distress syndrome (ARDS)?

What are the disadvantages of a fluid-conservative therapy for the treatment of acute respiratory distress syndrome (ARDS)?

How is a low-normal intravascular volume maintained during the treatment of acute respiratory distress syndrome (ARDS)?

How is a negative fluid balance facilitated in acute respiratory distress syndrome (ARDS)?

What is the role of e respiratory pulse pressure variation in the treatment of acute respiratory distress syndrome (ARDS)?

What is the role of noninvasive positive-pressure ventilation (NIPPV) in the treatment of acute respiratory distress syndrome (ARDS)?

In which patients with acute respiratory distress syndrome (ARDS) has noninvasive ventilation been studied?

When is noninvasive positive-pressure ventilation (NIPPV) contraindicated for the treatment of acute respiratory distress syndrome (ARDS)?

What are the goals of mechanical ventilation for the treatment of acute respiratory distress syndrome (ARDS)?

How is ventilator-associated lung injury prevented during the treatment of acute respiratory distress syndrome (ARDS)?

What is the benefit of mechanical ventilation with low tidal volumes for the treatment of acute respiratory distress syndrome (ARDS)?

What is the recommended tidal volume for mechanical ventilation in the treatment of patients with acute respiratory distress syndrome (ARDS)?

What is the role of PEEP in the treatment of acute respiratory distress syndrome (ARDS) when patients ventilate with lower tidal volumes?

When is the use of paralytics indicated for the treatment of acute respiratory distress syndrome (ARDS)?

What are the disadvantages to mechanical ventilation in the treatment of acute respiratory distress syndrome (ARDS)?

How is hypoxemia treated in acute respiratory distress syndrome (ARDS)?

What are the differences between positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) measures for the treatment of acute respiratory distress syndrome (ARDS)?

How is the optimal level of continuous positive airway pressure (CPAP) determined for the treatment of acute respiratory distress syndrome (ARDS)?

What is the role of the open lung approach in the treatment of acute respiratory distress syndrome (ARDS)?

What are the benefits to higher positive end-expiratory pressure (PEEP) for the treatment of acute respiratory distress syndrome (ARDS)?

What is the role of pressure-controlled ventilation (PCV) in the treatment of acute respiratory distress syndrome (ARDS)?

What are the benefits of using pressure-controlled ventilation (PCV) to treat acute respiratory distress syndrome (ARDS)?

What is the role of high-frequency ventilation (jet or oscillatory) for the treatment of acute respiratory distress syndrome (ARDS)?

What are the roles of partial liquid ventilation and airway pressure release ventilation for the treatment of acute respiratory distress syndrome (ARDS)?

What is the difference in oxygenation from the supine to the prone position in patients with acute respiratory distress syndrome (ARDS)?

What are possible mechanisms for the improvement of prone position oxygenation in acute respiratory distress syndrome (ARDS)?

What is the role of a tracheostomy in the treatment of acute respiratory distress syndrome (ARDS)?

What are the benefits of using extracorporeal membrane oxygenation (ECMO) in the treatment of acute respiratory distress syndrome (ARDS)?

When is the institution of nutritional support recommended for in the treatment of acute respiratory distress syndrome (ARDS)?

Which nutritional components have demonstrated improved outcomes in patients with acute respiratory distress syndrome (ARDS)?

What is the role of lower-volume trophic enteral feeding in the treatment of acute respiratory distress syndrome (ARDS)?

What activity restrictions are used in the treatment of acute respiratory distress syndrome (ARDS)?

What are the transfer considerations for patients with acute respiratory distress syndrome (ARDS)?

How is acute respiratory distress syndrome (ARDS) prevented?

Which specialist consultations are needed for the management of acute respiratory distress syndrome (ARDS)?

Medications

What is the role of medications in the treatment of acute respiratory distress syndrome (ARDS)?

Which medications are used in the treatment of acute respiratory distress syndrome (ARDS)?

What are the benefits of methylprednisolone in the treatment of acute respiratory distress syndrome (ARDS)?

Which medications in the drug class Corticosteroids are used in the treatment of Acute Respiratory Distress Syndrome (ARDS)?