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Investigations, treatment and complications of Adult respiratory distress syndrome

In this article, We are going to discuss the diagnostic investigations and methods of treatment and management of Adult respiratory distress syndrome .

Investigations

1) X-ray -7 Bilateral pulmonary infiltrates.
2) P02< 50
3) Normal. heart (normal ejection fraction of the Left ventricle by echo), late,
cardiac output decreased and be accompanied by metabolic acidosis and
tissue hypoxia.

Treatment of ARDS

 (Mortality> 50%)
1) Treatment of the Cause
2) O2 therapy with assisted ventilation PEEP (positive end expiratory pressure) to prevent alveolar collapse and increase lung volume. High frequency ventilation may be useful.
3) Steroid==>  improve capillary permeability
4) Diuretics
5) Inhaled nitric oxide and aerosolized prostacyclin may improve perfusion of ventilated lung units.
6) Surfactant replacement, TNF antibodies, III receptor antagonists and ketoconazole (inhibition of thromboxane synthesis).

Complications of ARDS

• Pneumothorax and pneumomediastinum (due to ventilators) may cause abrupt deterioration in patients with ARDS.
• Secondary bacterial infection
Adult Respiratory distress syndrome (ARDS) Causes and definition
Pathogenesis and Clinical picture of Adult Respiratory distress syndrome ARDS
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Tamer Mobarak

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