Material Educativo

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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