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Acute Respiratory Distress Syndrome (ARDS)

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Acute respiratory distress syndrome (ARDS) is a oxidative respiratory disease48 which is a problem in critically ill patients who are admitted to the intensive care unit (ICU)9. ARDS currently has a mortality rate of 20-40%9,11 which is associated with a high morbidity rate42,32. The original definition of ARDS was given in 1967 and was generalised as respiratory failure from non-cardiogenic pulmonary oedema which requires mechanical ventilation due to breathing difficulties and arterial hypoxemia33.Then the 4 point definition was used which the degree of hypoxemia, the level of positive end expiratory pressure (PEEP), the statics respiratory compliance and the extent of radiographic infiltrates to diagnose ARDS33. From 2012 the Berlin definition …show more content…

The more risk factors an individual has the increase in the likelihood of ARDS if a severe trauma is sustained33. Some of the major or most common causes of ARDS are pneumonia, a non-pulmonary septic infection, inhalation of the gastric contents or a major physical trauma33,9,32. Less common causes of ARDS include acute pancreatitis, transfusion and drug reactions and fungal or parasitic lung infections33. There are also risk factors associated with variation in genes for regulating inflammation, reactive oxygen species levels, endothelium function and regulation of apoptosis33. For example, a variation in the Fas gene for apoptosis can lead to a change in the promoter region of the Duffy antigen. This change leads to a greater risk of mortality during ARDS for people of African American …show more content…

There are two phases to ARDS pathogenesis; the acute phase and the resolving phase49. The acute phase is activated by DAMPS (danger associated molecular patterns) and begins the unregulated infiltration of the tissue by inflammatory cells causing accumulation of these cells49,33. These inflammatory cells produce oxidants and proteolytic enzymes49 leading to alveolar epithelial and endothelial injury which alters the permeability of the alveolar barrier33. They also produce cytokines which contribute to the uncontrolled activation of coagulation pathways33 which cause the lungs to become heavier due to protein rich oedema fluid, areas of haemorrhage12 and cellular debris filling the lungs33. The resolving phase in the pathogenesis of ARDS is includes phagocytosis of cellular debris and dead cells, repair of alveoli and resorption of oedema fluid49,12. If the patient survives ARDS they may recover with the full restoration of the alveolar structure, however, some patients develop fibrosis of the

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Acute is a condition in which carbon dioxide builds up very fast, before the kidneys can return the body to homeostasis. Symptoms of respiratory acidosis may include: Sleepiness, easy fatigue, confusion, and shortness of breath and lethargy. Treatment is aimed to the underlying disease, oxygen if the blood level is low, treatment to stop smoking, Noninvasive positive-pressure ventilation (called CPAP) or a breathing machine and some Bronchodilator drugs to reserve airway obstruction. Compensation refers to the body 's natural mechanisms of counteracting a primary acid-base disorder in an attempt to maintain homeostasis. In Respiratory Acidosis, the elevation in PCO2 result from a reduction in alveolar ventilation.

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Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.

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Neutrophils release of biochemical, humoral and cellular mediators that produce changes in the lung. Pulmonary capillary membrane permeability increased, destruction of elastin and collagen, formation of pulmonary microemboli, and pulmonary artery vasoconstriction. Pathophysiologic changes in ARDS are described in three phases. These three phases unfold sequentially over a period of several weeks to several months. First is exudative level.

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Annette’s reason for admittance at the hospital is an overall weakness, flu-like symptoms, and difficulty with breathing (Prizio, n.d.). She is diagnosed with diabetic acidosis, left upper lobe pneumonia, and a bacterial infection (Prizio, n.d.). Unfortunately, her condition becomes worse. Annette’s right lung collapses, her heart rate is irregular, and she has an episode of unresponsiveness that leads to mechanical ventilation (Prizio, n.d.). Annette has challenges weaning off the mechanical ventilation, which resulted in the placement of a tracheostomy and percutaneous endoscopic gastrostomy tube (Prizio, n.d.).

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The Effects of Sepsis Bundle on Mortality Rates: Background and Significance Historians in the medical field such as Hippocrates and Pasture have referenced symptomologies associated with sepsis of today (Angus & Van der Poll, 2013). Sepsis received its official definition of severe sepsis and septic shock in 1992; with terminology being based on the accompanying disease processes present (Angus & Van der Poll, 2013). The definition of severe sepsis indicates the presence of organ dysfunction along with sepsis. Additionally, septic shock is related to the presence of hypotension not responding to fluid resuscitation (Cawcutt, & Peters, 2014). A diagnosis of severe sepsis or sepsis shock has an increased risk of patient mortality, length of stay, and a higher probability of long-term disability (Cawcutt & Peters, 2014; Whittaker, et al. 2015).

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75% of ALS victims usually start with the stiffening of the limbs. The other 25% is presented with blubar symptoms. ALS can be managed through knowledge of the disease, adaptive or supportive treatments, or mechanism-specific treatment. There are many things that can go wrong when the disease process starts attacking the respiratory parts of a person’s body, such as making it difficult to swallow or even breathe. It’s very unfortunate but there is only one way to prolong life when the respiratory portion of the body is attacked.

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