Critical Care Medicine
Elyse Watkins, DHSc, PA-C, DFAAPA, NCMP
Acute respiratory distress syndrome, or ARDS, is comprised of a tetrad of clinical and diagnostic findings: (1) noncardiogenic pulmonary edema demonstrated by (2) extensive bilateral opacities on radiographic imaging, resulting in (3) severe refractory hypoxemia despite aggressive interventions with oxygen supplementation. These patients will often require artificial means of ventilation using a mechanical ventilator. Although the primary goal of mechanical ventilators is to promote the healing process by ensuring adequate gas exchange, poor ventilator management can actually lead to additional damage that complicates all aspects of patient care. These injuries, known as ventilator-induced or -associated lung injuries (VILIs/VALIs), can cause further harm and paradoxically extend a patient’s time on the ventilator. The five currently described VILIs are: volutrauma, barotrauma, biotrauma, atelectrauma, and shear-strain injury. This project aims to describe each of these in their physiological terms as well as proposed interventions for each. By understanding how to identify ad medically manage VILIs, patients with ARDS may be weaned from the ventilator quicker and experience better outcomes overall.
Farran MD. Identifying and Managing Ventilator-induced Lung Injury in ARDS. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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