Critical care management of the patient with acute respiratory distress syndrome (ARDS). Part 1: Pathophysiology and implications for mechanical ventilation.
Acute respiratory distress syndrome (ADRS) is a severe, life-threatening consequence of certain pulmonary and systemic insults. It is thought to result from a dramatic change in the permeability of the alveolar-capillary membrane, allowing the movement of fluid and proteins into alveolar air spaces. These changes are followed by inactivation of surfactant, bringing about a significant alteration in lung compliance. It is common for the devastating changes to lung function in ARDS to necessitate the patient being supported by mechanical ventilation. However, the poor compliance of the ARDS-affected lung can greatly increase the risk of ventilator induced lung injury. This has led to a concern that traditional ventilation strategies may in fact be perpetuating the very conditions they attempt to compensate for.
Nerlich
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NSW College of Nursing.
D000328:Adult; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008170:Lung Compliance; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods / Q000451:nursing*; D012128:Respiratory Distress Syndrome / Q000451:nursing* / Q000503:physiopathology