CORRECT ANSWERS GRADED A+
Gastric Aspirations and Near Drowning are examples of which type of lung injury?
Direct
Sepsis is caused by which type of lung injury?
Can be caused by both direct and indirect lung injuries.
Severe Trauma, Overdose and Burns are examples of which type of lung injury?
Indirect
Acute Repiratory Distress Syndrome (ARDS) is acute respiratory failure with the
following features:
~ hypoxemia that persists even with 100% O2
~ decreased lung (pulmonary) compliance
~ dyspnea
~noncardiac associated bilateral pulmonary edema
~ dense pulmonary infiltrates on x-ray (ground glass)
,Often ARDS occurs in people with no pulmonary disease after what?
an acute lung injury
Despite the different causes of acute lung injury - the trigger for ARDS is a
systemic inflammatory response
ARDS: The main site of injury in the lung is the
alveolar-capillary membrane
The alveolar capillary membrane is normally permeable to only what?
small molecules
When injured, the alveolar capillary membrane becomes
damaged and more permeable to intravascular fluid! The osmotic gradient "shifts"
which the allows debris, proteins & H2O into the alveloi!
The alveolar capillary membrane can be injured during what things?
sepsis - both direct and indirect.
pulmonary embolism - direct.
shock - indirect.
gastric aspiration - direct.
,Burns and inhalation injury - indirect.
The course of ARDS and its management are divided into 3 phases:
1. Injury/exudative phase.
2. Reparative/proliferative phase.
3. Fibrotic/chronic phase.
Injury/exudative Phase
Can last up to a week.
Damage to the alveolar / fluids flood in!
Gas exchange compromised (what findings would you see?).
Alveolar collapse.
Fluid inactivates surfactant / worsens hypoxemia
that does not respond to supplemental O2.
A potentially fatal syndrome of lung inflammation and injury
Acute Repiratory Distress Syndrome (ARDS)
ARDS is caused by:
DIRECT injury to lungs or INDIRECTLY by severe illness
, Examples of direct injuries that cause ARDS:
Pneumonia/Sepsis**
Gastric aspiration.
Lung contusion.
Fat emboli.
Near Drowning.
Inhalation injury.
Reperfusion: Lung transplant and/or Pulm embolectomy.
Examples of indirect injuries that cause ARDS:
Sepsis**
Severe trauma with shock & DIC.
Cardiopulm. bypass.
Overdose.
Acute pancreatitis.
TRALI.
Burns.
Reparative/proliferative phase
Can lasts up to 3 weeks.
Inflammatory response occurs/phase complete when the lung is dense with fibrous
tissue.