Adult respiratory distress syndrome

Adult respiratory distress syndrome Adult respiratory distress syndrome, in English, "Acute Respiratory distress syndrome, is an acute disease of the lungs with an increased risk for the patient's life. Respiratory distress syndrome is often associated with organic multiinsuficienta (eg CRS S - inflamtor systemic response syndrome) and shows a very high mortality rate.
Etiology
Respiratory distress syndrome occurs either in a systemic reaction of the body, either through direct deterioration of lung function.
Possible causes could be: - Shock; - Sepsis, S. I. R. S.; - Disseminated intravascular coagulation (in hemolysis, diabetic coma, pancreatitis); - Multiple trauma; - Trauma to the skull; - Severe burns; - Pulmonary Aspiration (gastric juice or water); - Inhalation injuries (smoke, flares); - Concetratie breathing a high oxygen; - Pneumonia
Pathogenesis
Repiratorie distress syndrome develops in several stages, beginning with an inflammatory reaction parenchymal lung disease and cause the rest induces pathological reactions. Pulmonary deterioration, with increased capillary permeability favors the formation of interstitial pulmonary edema. This inflammatory response increases neutrophil granulocytes, which increase, by releasing free radicals, inflammation. Under the action of inflammatory mediators is an alveolar edema, which causes destruction of alveolar surfactant on the surface, the formation of blood oxygenation microatelectazii and compromise. If respiratory distress syndrome was not fatal at this stage, the body initiates the healing mechanisms, replacing pneumocitele degraded tissue. Oxygenation process is limited long term by increasing the surface diffusion between blood and air. Most times you can not recover full respiratory function (respiratory failure).
Clinical
The first symptoms of respiratory distress are tachypnea (rapid rate of breathing) and dyspnea (difficulty breathing due to pulmonary edema). Typically appears hypoxemia (decreased amount of oxygen in arterial blood). Body temperature may decrease (hypothermia) or increase (hyperthermia or fever). Typically, clinical symptoms include: - Tachypnea; - Shortness of breath; - Cyanosis; - Anxiety; - Disorientation; Respiratory distress syndrome may be complicated, due to hypoxemia, with an organic multiinsuficienta. Degradation of the lungs cause an increased risk of pneumonia, which can complicate easy, given conditions with septicemia.
Diagnosis
Respiratory distress syndrome diagnosis can be made in case of: - Pulmonary edema without cardiac conditioning (auscultation, echocardiography); - Limiting massive oxygenation (blood gas analysis); - Bilateral infiltration, large, visible on chest radiography and computertomografie; Differential diagnosis is made with pulmonary embolism, left heart failure and severe pneumonia. For differentiation of left heart failure respiratory distress syndrome pulmonary arterial pressure is determined by catheterization.
Treatment
Treatment of respiratory distress syndrome is the intensive care unit, deoare may result in only a few hours to respiratory decompensation with necessary breathing. It must first establish the cause and fight as soon as artificial respiration with caution to practice a low-pressure breathing, which has not yet damaged lung segments affected. Hypercapny occasionally occur (increasing the concentration of carbon dioxide in the blood) in this case would, however be tolerated. In parallel, we recommend low dose heparin and parenteral feeding of patients. Treatment requires medical determination of maximal effort. In later stages of healing may be given corticosteroids to prevent pulmonary fibrosis. Mortality rate of respiratory distress syndrome is very high (55-70%).