Acute respiratory distress syndrome is a dangerous lung disease that prevents enough oxygen from reaching the lungs. Acute respiratory distress syndrome leads to an increase in fluid accumulation in the air sacs. This fluid prevents enough oxygen from reaching the lungs. Fluid accumulation also makes the lungs heavy and stiff, and the lungs lose their ability.
acute respiratory distress syndrome Noncardiac pulmonary edema ) is a syndrome that is accompanied by sudden and progressive edema, increased bilateral infiltrations, decreased lung capacity and hypoxia despite oxygen therapy. ARDS It is caused by inflammation that leads to alveolar capillary membrane damage. People at risk of ARDS are those who have experienced direct lung injury (such as aspiration, smoke inhalation) or indirect injury (such as shock). Death is mainly caused by multiple organ failure with blood infection (sepsiss). The mortality rate of ARDS is about 25 to 58%.
Clinical protests
Examination and diagnostic findings
- Brain natriuretic peptide serum level
- Eco cardiography
- Catheterization of the pulmonary artery
Medical measures
- Identify and treat underlying conditions
- Use of supportive treatment
- Intubation and mechanical ventilation
- Support the circulatory system
- Sufficient circulating volume
- Nutritional support
- Use of oxygen therapy whenever the patient shows the first sign of hypoxemia.
- Checking the values of arterial blood gases (ABG), pulse oximetry and pulmonary function test
- As the disease progresses, the use of positive end-expiratory pressure (PEEP)
- Treatment of hypovolemia with great care so that the patient does not experience an increase in fluid volume (inotropic or vasopressor may be prescribed).
- There is no specific drug treatment for ARDS and its treatments are supportive. A number of drugs are being studied and investigated in order to treat and prevent this complication, for example (substitution treatment with surfactant, drugs to prevent pulmonary hypertension and antiseptic drugs).
- Nutritional support (35 to 45 kcal/kg daily)
Nursing measures
Detailed and frequent examination of the patient and examination of the effectiveness of treatments, for example:
- Oxygen administration
- Therapeutic nebulizer
- Respiratory physiotherapy
- Intubate or create a tracheostomy for the patient
- Mechanical ventilation
- suction
- Bronchoscopy
Attention to other patient needs such as:
- positioning
- Relieve anxiety
- rest
Identifying any factor that causes problems in the patient’s breathing and can lead to anxiety, such as:
In order to reduce oxygen consumption, sedatives may be used, also sedatives can facilitate the operation of ventilators to create better ventilation and lead to reducing the patient’s anxiety.
If the sedatives were not effective, paralyzing drugs (that short effect are) is used.
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In this case, the patient should have been prescribed a sedative and the patient should not be in pain
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Reassure the patient that the paralysis is due to the medication and will be temporary
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Explain the purpose and effect of paralytics to the patient’s family members.
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A patient who has received a paralytic should be carefully monitored and controlled
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Make sure the patient is not disconnected from the ventilator.
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Also, make sure that all mechanical ventilation system warning systems are working properly
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Monitor the patient directly
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Reduce the side effects of neuromuscular blocking drugs as much as possible and anticipate the patient’s possible needs regarding pain and discomfort.
- Source – nursing station
February 9, 1392 23:22
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