An Insight about Acute Respiratory Distress Syndrome (Coursework Sample)
An 80 year old, frail woman living in a nursing home finishes her dinner and goes to the common room to play dominoes. She vomits and aspirates some of the vomit. She appears to be fine after she stops coughing. She is able to return to her previous level of functioning. Three days later, she reports having a very hard time breathing. She is given oxygen via nasal cannula, which only slightly eases her distress. Over the next 48 hours, her dyspnea worsens and she is sent to the hospital. A chest xray shows bilateral infiltrates and poor aeration. Within hours, she is placed on a ventilator with the diagnosis of Acute Respiratory Distress Syndrome (ARDS).
a. Describe the pathophysiologic processes of ARDS and relate them to this patient.
b. State which direction the oxyhemoglobin dissociation curve would shift in this patient and give rationale for your choice.
c. Relate how you would change the events described to minimize the chances that she would develop ARDS.
Acute Respiratory Distress Syndrome (ARDS)
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Acute Respiratory Distress Syndrome (ARDS)
Case Study
An 80-year-old, frail woman living in a nursing home finishes her dinner and goes to the standard room to play dominoes. She vomits and aspirates some of the vomit. She appears to be okay after she stops coughing. She can return to her previous level of functioning. However, three days later, she reports having a difficult time breathing. As a result, she is given oxygen via nasal cannula, which only slightly eases her distress. Over the next 48 hours, her dyspnea worsens, and she is sent to the hospital. A chest x-ray shows bilateral infiltrates and poor aeration. Within hours, she is placed on a ventilator to diagnose Acute Respiratory Distress Syndrome (ARDS).
Pathophysiologic processes of ARDS
Acute lung injury can either be indirect, with the agent causing damage arriving at the lungs via the bloodstream, or direct. The agent was causing damage reaching the lungs through the airways or trauma to the chest. The most affected areas in ARDS are the air sacs (alveoli), where gaseous exchange occurs. The thin wall between the blood and air is composed of the alveolar wall and the blood capillary. However, the alveolar wall is very delicate; it has a width of fewer than 0.5 micrometers (Gorguner and Akgun, 2010). In ARDS, both the alveolar wall and the blood capillary are injured, irrespective of the initiating process; hence, the latter prevents or stops exchanging gases in the lungs.
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