Trauma ICU Rounds – ARDS Fundamentals I: Classification, Pathophysiology & Initial Vent Management

Originally posted on Trauma ICU Rounds on February 2, 2021. Follow Trauma ICU Rounds (@traumaicurounds) and Dr. Kim (@dennisyongkim) to learn more on simplifying trauma critical care together.


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Back to the basics! In this episode we review the evolving criteria,  etiologies, and pathophysiology of ARDS. A brief review of ventilator induced lung lung injury and initial vent setup provide the groundwork for future episodes exploring how to troubleshoot the vent and therapies for ARDS that have been shown to improve oxygenation and mortality. Please check out Episodes

Objectives:

By the end of Rounds, you should be able to:

1. Identify the key diagnostic criteria for ARDS

2. Discuss the most common pulmonary and non-pulmonary etiologies for this syndrome

3. Understand the 3 phases of ARDS and the key pathophysiologic features that accompany this syndrome

4. Describe the 4 types of ventilator induced lung injury or VILI which, I think is important as it really lays the foundation for understanding the basics of initial ARDS management.

5. Discuss the initial ventilator setup for patients with ARDS

References

Acute Respiratory Distress Syndrome Network, Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801. PMID: 10793162.

Thompson BT, Chambers RC, Liu KD. Acute Respiratory Distress Syndrome. N Engl J Med. 2017 Aug 10;377(6):562-572. doi: 10.1056/NEJMra1608077. PMID: 28792873.

Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1334-49. doi: 10.1056/NEJM200005043421806. PMID: 10793167.

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