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UMS Acute Respiratory Distress Syndrome Presentation

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Health & Medical

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University of Medical Sciences

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Dr. Owolade ‘SSS Department of Medicine University of Medical Sciences Ondo  Definition  Pathophysiology  Aetiology  Clinical features  Investigation  treatment  Sudden onset severe dyspnoea with associated hypoxemia, diffuse pulmonary infiltrates with no evidence for cardiogenic pulmonary oedema.  Acute severe dyspnoea.  Hypoxemia- PaO2/ FiO2 <200mmHg  Bilateral pulmonary infiltrates  PCWP <18mmHg  Reduced lung compliance  NB: In ALI; PaO2/ FiO2 <300mmHg . 1. Direct or indirect injury to the alveolus causes alveolar macrophages to release proinflammatory cytokines Ware et al. NEJM 2000; 342:1334 2. Cytokines attract neutrophils into the alveolus and interstitum, where they damage the alveolar-capillary membrane (ACM). Ware et al. NEJM 2000; 342:1334 3. ACM integrity is lost, interstitial and alveolus fills with proteinaceous fluid, surfactant can no longer support alveolus Ware et al. NEJM 2000; 342:1334  Anxiety, agitation, cold extremities  Febrile/hypothermia  Cyanosis  Dyspnoea  Tachypnoea  Tachycardia  Widespread crackles  Rhonchi  Features of the underlying disease  Chest Xray  Arterial Blood Gases  Pulse oximeter  Pulmonary Capillary Wedge Pressure  Electrocardiography/ Echocardiography  Bronchoscopy  Lung biopsy  Full Blood Count  Chest CT  ICU admission  Prone position  Mechanical ventilation support  Fluid therapy  Diuretics ...
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