ARDS Fluid Management,Mechanical Ventilation,Prone Position Ventilation

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Pediatric Emergencies

ARDS

Pediatric Emergencies in Children

Acute Respiratory Distress Syndrome (ARDS)

Scorpion Sting

Vascular Access in Pediatrics

Mechanical Ventilation Practical Guidelines

Management Of Septic Shock

Pediatric Emergencies Cases And Diagnosis

Paediatric Resuscitation Update

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

"Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

FIND DIAGNOSIS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

Management and Prognosis

Related topics

Introduction Predisposing Factors and Clinical Features

Lab Investigations and Pathophysiology

Dr Vishal Dublish, Dr Ira Shah

Management:

Once ARDS sets in, it is a challenging task to manage. Still supportive therapy remains the first line of treatment.

General supportive management:

Treatment of Sepsis: Sepsis should be aggressively treated with an adequate antibiotic regimen. Nosocomial infections should be prevented.
Fluid management: It is suggested that reduced pulmonary artery pressure, weight loss and fluid restriction may improve outcome in ARDS including time on mechanical ventilation and days in intensive case unit. Increased intravascular hydrostatic pressure causes more alveolar fluid leakage and oxygenation worsens. Fluid restriction or diuretic may worsen shock by reducing cardiac output and organ perfusion. Optimal fluid management for patients with ARDS requires a balancing act between fluid restriction and fluid administration. Recent recommendations are in favor of small reduction in intravascular volume with diuretic use causing significant reduction in the extravascular lung water.
Mechanical ventilation: is the mainstay of treatment. Goals of ventilatory support include:
- Improving gas exchange
- Reduce work of breathing
- Avoiding oxygen toxicity
- Minimizing high airway pressures
- Promoting alveolar recruitment
- Avoiding further lung damage and
- Permitting lung tissue healing

This approach is called as "LUNG PROTECTIVE AND PRESSURE LIMITED STRATEGY"

Recent recommendations are:

Using small tidal volumes (5-8 ml/kg).
Longer inspiratory time via volume cycled ventilation or pressure targeted ventilation not to exceed transpulmonary pressure
30-35 cm of water.
Upward titration of PEEP (Peak end expiratory pressure).
Allowing permissive hypercapnia, if necessary to reduce transpulmonary pressures.

Prone position ventilation: May improve oxygenation in more than 75% of ARDS patients. Proposed mechanisms are:

Redistribution of ventilation in the dependent lung zones with improved alveolar recruitment.
Increased drainage of airway and pharyngeal secretions
Redistribution of perfusion to less injured lung regions
Increased functional residual capacity (FRC)
Change in regional diaphragm motion

Limitations - Chances of extubation, central venous catheter removal, etc.

Next : Management and Prognosis Continued...

Mail To Your Friend

Print This Article

TOP SEARCH TERMS

ARDS Pathophysiology

ARDS Management

Clinical manifestations of Scorpion Sting

Vascular access types

Central venous access

Mechanical Ventilation Objectives

Ventilation Strategies

Septic Shock Management

Herpes Encephalitis

Tachypnea and Abdominal Pain

The Stomach flu

Artificial Circulation Alternative Methods

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Head circuferences Calculator

Mid parental height Calculator

Body surface area Calculator

BMR Calculator

Temperature Calculator

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids