Adult respiratory distress syndrome (ARDS) is often induced based on treatment prescribed by the provider. Discuss types of treatment that can lead to ARDS. Explain the assessment and radiographic findings of ARDS in a patient. Describe concerns that exist when managing the patient via the ventilator. Use research to support your response. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources. Need completed by wednesday 9/14

Introduction:

Adult respiratory distress syndrome (ARDS) is a severe and potentially life-threatening condition characterized by acute respiratory failure due to the damage and inflammation of the alveolar epithelium and the capillary endothelium within the lungs. ARDS can be induced by various treatment modalities, which will be discussed in this paper. The assessment and radiographic findings of ARDS in a patient will also be described, along with the concerns that exist when managing the patient via the ventilator.

Types of treatment that can lead to ARDS:

There are several types of treatment that can potentially lead to the development of ARDS. One common cause is mechanical ventilation, particularly if it is provided at high levels of pressure or volume. Ventilator-associated lung injury (VALI) occurs when mechanical ventilation causes further lung damage due to overdistention and shear stress on the alveoli. This inflammatory response can worsen the existing lung injury and contribute to the development of ARDS (Gattinoni et al., 2016).

Another treatment modality associated with the development of ARDS is the use of positive end-expiratory pressure (PEEP) during mechanical ventilation. While PEEP can improve oxygenation in patients with hypoxemia, it can also cause barotrauma and volutrauma, leading to lung injury and potentially ARDS (Fan & Brodie, 2018).

Furthermore, certain medications and therapeutic interventions can also contribute to the development of ARDS. For example, chemotherapy drugs such as bleomycin and busulfan have been linked to the development of lung injury and subsequent ARDS (Chatterjee et al., 2020). Additionally, radiation therapy to the chest can cause inflammation and fibrosis in the lungs, potentially leading to ARDS (Robnett et al., 2000).

Assessment and radiographic findings of ARDS:

The assessment of a patient with ARDS involves a comprehensive evaluation of their respiratory status, oxygenation, and overall clinical condition. These assessments are crucial for determining the severity of ARDS and guiding treatment decisions. Common assessment findings in patients with ARDS include dyspnea, tachypnea, hypoxemia, and respiratory distress (Thompson et al., 2017).

Radiographic imaging, particularly chest X-rays and computed tomography (CT), play a crucial role in the diagnosis and assessment of ARDS. In the early stages, chest X-rays may show only minimal abnormalities, such as bilateral patchy opacities or ground-glass opacities. As the disease progresses, diffuse bilateral infiltrates on chest X-ray become more prominent and indicative of ARDS (Rubenfeld et al., 2012). CT scans can provide more detailed information about the extent and distribution of lung involvement in ARDS, showing findings such as consolidations, ground-glass opacities, and interlobular septal thickening (Das et al., 2017).

Concerns when managing the patient via the ventilator:

Ventilatory management is a cornerstone of ARDS treatment, but it can also pose significant challenges and potential complications. One such concern is ventilator-induced lung injury (VILI), which refers to additional lung damage caused by mechanical ventilation. Strategies to minimize VILI include the use of lung-protective ventilation strategies, such as low tidal volumes and limited plateau pressures, which have been shown to improve mortality in ARDS patients (Gattinoni et al., 2020).

Another concern when managing ARDS patients via the ventilator is the risk of ventilator-associated pneumonia (VAP). ARDS patients are at an increased risk of developing VAP due to impaired lung defenses and prolonged mechanical ventilation. Preventive measures, such as early mobility, sedation minimization, and oral care, should be implemented to reduce the risk of VAP (Kalil et al., 2016).

Additionally, the use of PEEP can have both beneficial and detrimental effects. While PEEP can improve oxygenation and recruit collapsed alveoli, excessive levels can cause hemodynamic compromise and worsen lung injury. Optimizing PEEP settings based on individual patient needs and monitoring closely for potential complications is crucial in ARDS management (Fan & Brodie, 2018).

In conclusion, ARDS can be induced by various treatment modalities, including mechanical ventilation, the use of PEEP, and certain medications or therapeutic interventions. Assessment of ARDS includes evaluating the patient’s respiratory status and oxygenation, while radiographic findings on chest X-rays and CT scans play a crucial role in diagnosis and monitoring. When managing ARDS patients via the ventilator, concerns include the risk of ventilator-induced lung injury and ventilator-associated pneumonia, as well as optimizing PEEP settings. Implementing lung-protective ventilation strategies and preventive measures can help improve outcomes for patients with ARDS.