ARDS (Acute Respiratory Distress Syndrome)
Clinical Description – ARDS
Care of the hospitalized child experiencing new onset of respiratory failure within 7 days of the initial insult, including bilateral infiltrates, an acute deterioration in oxygenation from baseline and refractory hypoxemia that cannot be explained by cardiac failure or fluid overload.
Key Information
- Volume-targeted ventilation allows for consistent lung volumes and real-time pressures as lung compliance changes.
- Higher PEEP (positive end expiratory pressure) and prone positioning may be more beneficial for those with moderate-severe ARDS (acute respiratory distress syndrome).
- Refractory hypoxemia, lung compliance and respiratory mechanics may be used to guide an optimal PEEP (positive end expiratory pressure) strategy.
- Evidence does not support routine use of inhaled nitric oxide, beta-2 agonist medication or high-frequency oscillatory ventilation in the pediatric population.
Clinical Goals
By transition of care
A. The patient will demonstrate achievement of the following goals:
- Effective Oxygenation
B. Patient, family or significant other will teach back or demonstrate education topics and points:
- Education: Overview
- Education: Self Management
- Education: When to Seek Medical Attention
Correlate Health Status
Correlate health status to:
- history, comorbidity, congenital anomaly
- age, developmental level
- sex, gender identity
- baseline assessment data
- physiologic status
- response to medication and interventions
- psychosocial status, social determinants of health
- barriers to accessing care and services
- child and family/caregiver:
health literacy
cultural and spiritual preferences - safety risks
- family interaction
- plan for transition of care
ARDS (Acute Respiratory Distress Syndrome)
Signs/Symptoms/Presentation
- breath sounds abnormal
- breath sounds diminished
- lung compliance decreased
- minute volume increased
- oxygen demand increased
- oxygen index increased
- PaO2/FiO2 ratio less than or equal to 300 mmHg
- plateau pressure (lung) increased
- work of breathing increased
Vital Signs
- heart rate increased
- respiratory rate increased
- blood pressure increased or decreased
- SpO2 (peripheral oxygen saturation) decreased
Laboratory Values
- ABG (arterial blood gas) abnormal
- PaO2 (partial pressure of arterial oxygen) decreased
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