Coursename
Acute respiratory distress syndrome is a disorder which was first described in 1967. It is one of the most severe and dangerous respiratory system disorders, which is still despite advances of the modern medicine, is associated with high mortality. It may be caused by direct (pneumonia, aspiration, toxic substances inhalation) or indirect lung injury (severe hemorrhage, burns, sepsis, trauma, blood transfusions) (York and Kane 153-158).
Under the influence of the above-written factors in the pulmonary capillaries and interstitial lung tissue accumulates a large number of activated leukocytes and platelets that secrete many biologically active substances. These substances include proteases, prostaglandins, lipid peroxidation products, leukotrienes. The exudation of these mediators induce the inflammation, dealing damage to the alveolar epithelium and vessels, changing their tone and reactivity. Biologically active substances significantly increase vascular permeability, thus happens major exudation of the plasma and red blood cells in the alveoli and interstitial tissue which leads to the development of pulmonary edema and atelectasis (York and Kane 153-158). As a result of inflammation, edema and surfactant deficiency elasticity of the alveolar walls is reduced, which also promotes atelectasis development. Hypoxia, which develops as a result of these changes, can be fatal (Live Science). Diagnosis of this condition is complicated because the disease is masked by symptoms which are similar to pneumonia or pulmonary hemodynamic edema. To facilitate the task healthcare providers should use the ARDS criteria from American-European Consensus. According to these criteria, ARDS should have acute onset - commonly symptoms appear between four and seventy-two hours after the lung injury. The second evidence of ARDS is a radiographic evidence of bilateral infiltrates in the chest. The third criterion includes the wedge pressure of the pulmonary capillaries more than 18 mmHg with no evidence of left atrial hypertension. The last verifying point in the diagnosis of the ARDS is the PaO2/FIO2 ratio, which should be less than 200.
Despite the advances of medicine, ARDS remains a very dangerous condition, which is also complicated by the presence of only symptomatic treatment to deal with it. Many medications, which were widely used in the treatment of this condition in the past are not recommended nowadays. However, development of more complicated medical ventilators and advances of the extracorporal oxygenation methods may increase the survivability of patients in the future.
Works Cited:
Science, Live. "Respiratory System: Facts, Function And Diseases". Live Science. N.p., 2016. Web. 26 May 2016.
Sud, S. et al. "Effect Of Prone Positioning During Mechanical Ventilation On Mortality Among Patients With Acute Respiratory Distress Syndrome: A Systematic Review And Meta-Analysis". Canadian Medical Association Journal 186.10 (2014): E381-E390. Web. 26 May 2016.
York, Nancy L. and Christy Kane. "Trends In Caring For Adult Respiratory Distress Syndrome Patients". Dimensions of Critical Care Nursing 31.3 (2012): 153-158. Web. 26 May 2016.
