acute respiratory failure in adult.pptx

7/27/2019 Acute Respiratory Failure in Adult.pptx

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Acute Respiratory Failure inAdult

(Respiratory Distress Syndrome)

Marion SorianoFatima Love Ariate


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Initially called the adult respiratory distress syndrome, it

is now called the acute respiratory distress syndrome

because it also affects children

Results from increased permeability of the alveolar

capillary membrane

clinical syndrome is characterized by: a sudden and progressive pulmonary edema increasing bilateral infiltrates on chest x-ray

hypoxemia unresponsive to oxygen supplementation regardless

of the amount of PEEP


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Causes Aspiration (gastric secretions, drowning, hydrocarbons)

Drug ingestion and overdose

Hematologic disorders (disseminated intravascular

coagu-lopathy [DIC], massive transfusions,cardiopulmonary by-pass)

Prolonged inhalation of high concentrations of oxygen,

smoke, or corrosive substances


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Causes Localized infection (bacterial, fungal, viral pneumonia)

Metabolic disorders (pancreatitis, uremia)

Shock (any cause)

Trauma (pulmonary contusion, multiple fractures, head injury)

Major surgery

Fat or air embolism

Systemic sepsis


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PATHOPHYSIOLOGY


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Modifiable-lifestyle-Diet

-Infections-Chemicals-Trauma

Non-modifiable

-Age-Gender

Lung injury

Platelet aggregation


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Platelet aggregation

Increase of capillary permeability

Release of Serotonin, Bradykinin, Histamine

Pulmonary Edema


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Damage to the Type II endothelial cells

Decrease in Surfactant production

Alveolar Collapse

Fibrosis


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Diagnostic Test


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Chest X-Ray

Can reveal which parts of your lungs have fluid in them and whether

your heart is enlarged.

Can provide detailed information about the structures within the

heart and lungs.

CT Scan


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Blood Test

Such as CBC, blood chemistry, blood cultures. These tests help find

the cause of ARDS such as an infection

This test looks at the sputum coughed up from your lungs. And can

help find the cause of an infection.

Sputum Cultures


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Arterial Blood Gas Test

This blood test shows the oxygen level in your blood. A low level of

oxygen level in the blood may be a sign of ARDS.

Because signs and symptoms of ARDS are similar to those of

certain heart problems, your doctor may recommend

Electrocardiogram This test tracks the electrical activity in your

heart.

Echocardiogram This test can reveal problems with the structures

and the function of your heart.

Heart Test


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Medication

Antibiotics Given to patients for infection. Such as pneumonia.

Steroids To reduce inflammation.

Levophed This medication is given to patient with ARDS to support

blood pressure and improve oxygenation.

Sedatives are given to keep the patient calm and help them toleratebeing on a ventilator.

Inhaled Medications

Nitric Oxide

Inhaled Nitric Oxide or INO given to improve circulation within thepulmonary system

Albuterol Inhaled medication that helps keep the airways open.


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Nursing Management


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Oxygenation

Supplemental Oxygen For milder symptoms or astemporary measure. Oxygen may be delivered through a mask that

fits tightly over your nose and mouth.

Mechanical Ventilation

Most people with ARDS will needthe help of a machine to breathe. A Mechanical Ventilator pushes

air into your lungs and forces some of the fluid out of the air sacs.


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Fluid and Electrolyte

Carefully managing the amount of intravenous fluid is crucial.

Too much fluid can hinder the lungs ability to oxygenate the

blood.

Too little fluid can make the body dehydrated , making it difficult

to send enough blood and oxygen to the organs and extremities.Adequate Nutrition

The nutritional needs of the critically ill patient with ARDS must alsobe addressed because the caloric requirement increases due to

stress, sepsis, trauma, and use of mechanical Ventilation.

If the nutritional requirements are not met, respiratory function isimpaired as result to negative nitrogen balance.


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Surgical Management

acute respiratory failure in adult.pptx

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