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Adult Respiratory distress Syndrome (ARDS) Variety of unrelated massive insults injure gas exchanging surface of Lungs First described as clinical syndrome in 1967 by Ashbaugh & Petty Clinical terms synonymous with ARDS Acute respiratory failure Capillary leak syndrome Da Nang Lung Shock Lung Traumatic wet Lung Adult hyaline membrane disease Risk Factors in ARDS Sepsis 3.8% Cardiopulmonary bypass 1.7% Transfusion 5.0% Severe pneumonia 12.0% Burn 2.3% Aspiration 35.6% Fracture 5.3% Intravascular coagulopathy 12.5% Two or more of the above 24.6% PATHOPHYSIOLOGY AND PATHOGENESIS Diffuse damage to gas-exchanging surface either alveolar or capillary side of membrane Increased vascular permeability causes pulmonary edema Pathology: fluid and RBC in interstitial space, hyaline membranes Loss of surfactant: alveolar collapse CRITERIA FOR DIAGNOSIS OF ARDS Clinical history of catastrophic event Pulmonary or Non pulmonary (shock, multi system trauma) Exclude chronic pulmonary diseases left ventricular failure
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