1. Acute Respiratory Distress#1. Syndrome (ARDS): Definition, Incidence, and Outcome
1. Acute Respiratory Distress Syndrome (ARDS): Definition, Incidence, and Outcome
1.1 Definition of ARDS – history , 1967, 12 case sudden respiratory failure , ARDS
ไม่มี hx cardiac / pulm disease -> แต่ rapidly develop ac hypoxia , stiff lungs , diffuse bilateral alveolar infil
7/12 case death
histo พบ hyaline memb , edema , cell necrosis , fibrosis
1971 principle Rx ARDS – mechanical ventilation using high FiO2 , positive end expiratory pressure PEEP
p 2 cyanosis -refractory to O2 เป็น criteria for ARDS
hypoxia < 70mmHg ทั้งๆที่ให้ FiO2 อย่างน้อย 0.5 c PEEP
pulm wedge p. < 18 mmHg ,เพื่อ r/o cardiogenic pulm edema