Pulmonary Concepts In Critical Care

ARDS Adult Respiratory Distress Syndrome.

ARDS Adult Respiratory Distress Syndrome.

Acute lung injury characterized by alolar and capillary leak refractory hypoximia.

Acute Lung Injury – a precursor to ARDS, lesser level of injury, severe oxygenation
abnormality presence of diffuse parenchymal infiltrates on chest x-ray (three or four
quadrants), hypoxemia as manifested by a PaO2/FiO2 (fraction of inspired oxygen)
ratio of <300 torr, and a pulmonary capillary wedge pressure of <18 mmHg, or no
clinical evidence of elevated left-sided heart filling pressure.

Adult or Acute Respiratory Distress Syndrome – same criteria as acute lung injury
(ALI) except more profound severe oxygenation abnormality with a PaO2/FiO2 ratio
of <200 torr.  The pathophysiology of ARDS is characterized by a cascading effect in
a proinflammatory response by the body. 

Corticosteroids – hormones which are steroids and produced by the adrenal cortex and
are also produced exogenous (artificially from external sources). ARDS is an inflammatory
process and administration of steroids (drugs) may suppress the inappropriate inflammatory
mechanisms occurring in ARDS. A number of studies have shown administration in early
stage of sepsis and ARDS results in no appreciable benefits. Stronger evidence
exists that use in the late stages of ARDS. 

Landau, Simon, The Critical Care Handbook, 5th ed. 1995, Chapter 4, 298-309

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