Dear Friends.. ARDS is an important clinical condition which needs discussions.. ARDS (Acute respiratory distress syndrome) It is an Acute onset of rapidly progressive dyspnea, tachypnea, and hypoxemia. DIAGNOSTIC CRITERIA for ARDS: (1)acute onset (2)PaO2/FiO2 of 200 or less regardless of PEEP (3)bilateral infiltrates seen on frontal chest radiograph and (4)no clinical evidence of left atrial hypertension(pulmonary artery wedge pressure of 18 mm Hg or less if measured) ARDS is believed to occur when a pulmonary or extrapulmonary insult causes the release of inflammatory mediators which causes damage to the vascular endothelium and alveolar epithelium… leading to pulmonary edema, hyaline membrane formation, decreased lung compliance, and poor air exchange. ARDS has to be differentiated from congestive heart failure, which usually has signs of fluid overload, and from pneumonia. I have attached tables to help you differentiate.. TREATMENT It is largely supportive and includes… (1)mechanical ventilation with a strategy of Low tidal volume & high positive end-expiratory pressure. (2)prophylaxis for stress ulcers and venous thromboembolism (3)nutritional support (4)treatment of the underlying injury. (5)conservative fluid therapy Applying above strategy of  treatment improves outcomes. A spontaneous breathing trial is indicated as the patient improves and the underlying illness resolves. Most cases of ARDS in adults are associated with pulmonary sepsis or nonpulmonary sepsis. Risk factors include those causing (1)Direct lung injury (e.g., pneumonia, inhalation injury, pulmonary contusion) (2)Indirect lung injury (e.g., nonpulmonary sepsis, burns, transfusion-related acute lung injury). Risk factors in children are similar to those in adults, with the addition of age-specific disorders such as … Respiratory syncytial virus infection and near drowning aspiration injury. Pharmacologic options for the treatment of ARDS are limited. Although surfactant therapy may be helpful in children with ARDS,   The use of corticosteroids is controversial. Randomized controlled trials and cohort studies tend to support early use of corticosteroids However, no consistent mortality benefit has been shown with this therapy. Mortality is between 34 and 55 percent in different recent trials and most deaths are due to multi-organ failure. Thanks Dr K N Poddar

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Wonderful post from dear Poddar again. Nice topic, but tough too, made easy by Dr Poddar. Starting from Diagnostic criteria Treatment. As usual Poddar mark of teaching, unparalleled. None other than Dr Poddar can do this so understandable. Thanks again dear Poddar for your continuous teachings on Pulmonary Medicine. Pulmonary Medicine made easy. Author Dr K.N.Poddar Calcutta.

Thanks Dr Dr. Mohan.. We are fortunate to have you in CUROFY.. your appreciation help us to perform even better
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Again a wonderful post from Dr Poddar sir ARDS is an emergency which needs prompt attention and treatment . Very clear and simple way to differentiate between ARDS, Heart failure, and Pneumonia. Thanks for sharing the evidence based post sir

Many thanks Dr Devi.. For your continued support to my posts..
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very useful post . thanks for poating important topic . hope you will keep educaring us the same way as you are Sir

typing error posting
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poddar sir what is your view regarding prone ventilltion as far as I am concern it improves oxygenation but not modifies mortality

Thanks Dr Sinha for your interest in the topic.. We have abandoned prone positioning. Because found no better and problems in nursing and assessment of the patient condition..
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brief and informative

Thanks Dr Sharma for your interest in this post
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Helpful. What about lung recruitment therapy in this condition

Thanks Dr Mazumdar
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very nice , made easy atleast for other specialists other than pulmonologist , I appreciate and remain obliged Thanx

Thanks Dr Verma.. I simplify my post to make it useful to most of us
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very very useful post.useful in ER,ICU.thanks for sharing

Thanks Dr Patil
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thanks

Thanks Dr Patil
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Nice post sir

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