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Acute Respiratory Distress Syndrome – ARDS: Clinical Cheat Sheet

An acute diffuse, inflammatory lung injury, leading to
Distress Syndrome ... Cheat Sheet ... leading to increased pulmonary ... Summary #CheatSheet #Diagnosis ... #Management #CriticalCare
Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS) 
- Respiratory symptoms must have begun within one
Respiratory Distress ... be present on a chest ... lobar collapse, lung ... Definition #Criteria #Diagnosis ... #CriticalCare
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
Weakness, Loss of Chest ... Elasticity (flail chest ... Left Shunt - Anatomic ... : Atelectasis, ARDS ... #differential #diagnosis
Upper Lobe Lung Diseases - STAR CHASERS Mnemonic

S - Silicosis
T - Tuberculosis
A - Ankylosing Spondylitis
R -
Upper Lobe Lung ... caused by a rigid chest ... With Upper Lobe ... edema in acute ... #differential #diagnosis
The Berlin Definition of Acute Respiratory Distress Syndrome (ARDS)

Chest imaging - Bilateral opacities—not fully explained by
Chest imaging ... effusions, lobar/lung ... >= 5cm H2O #Diagnosis ... #CriticalCare # ... ARDS #Acute #Respiratory
Amiodarone Induced Lung Toxicity Summary

Who?
• 5% of patients
• Dose ≥ 400 mg per day

How?  Possible
organizing pneumonia, ARDS ... toxicity (e.g., acute ... respiratory distress ... Pleuritic chest ... reticular opacities on chest
Uncommon Causes of Noncardiogenic Pulmonary Edema (NCPE) - Differential Diagnosis Framework

High Altitude Pulmonary Edema:
 • Accumulation
- Differential Diagnosis ... blood cells in the lung ... respiratory failure or ARDS ... infiltrates on chest ... scattered crackles, chest
TRALI Diagnostic Criteria
TRALI type 1 - Patients who have no risk factors for ARDS and meet
Acute onset, Hypoxemia ... on imaging (eg. chest ... chest CT, or ultrasound ... #Criteria #pulmonary ... #criticalcare
Mycoses

HISTOPLASMOSIS
• Inhalation of conidia → Yeast → travel to lymph nodes → spread in body
• Bird
presents with acute ... aches, joint pain, chest ... yeast • At risk: AIDS ... change in the lungs ... nails, bronchi, lungs
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
murmur 3/6) - Pulmonary ... ACEi/ARBs - Hold ... change CV risk Chest ... unless prior heart/lung ... stratification #diagnosis