section name header

Table 47.7

Management of Acute Respiratory Distress Syndrome (ARDS)

ElementComment
Transfer to ICUARDS is usually part of multiorgan failure
OxygenationIncrease inspired oxygen, target PaO2 >8kPa
Ventilation will be needed if PaO2 is <8kPa despite FiO2 60%
Ventilation in the prone position improves oxygenation
Haemoglobin should be kept around 10g/dl (to give the optimum balance between oxygen-carrying capacity and blood viscosity)
Fluid balanceAcute kidney injury is commonly associated with ARDS
Consider early haemofiltration
Prevention and treatment of sepsisSepsis is a common cause and complication of ARDS
Culture blood, tracheobronchial aspirate and urine daily
Treat presumed infection with broad-spectrum antibiotic therapy
NutritionEnteral feeding if possible, via nasogastric tube if ventilation needed
DVT prophylaxisGive DVT prophylaxis with stockings and LMW heparin
Prophylaxis against gastric stress ulcerationGive proton pump inhibitor

DVT, deep vein thrombosis; ICU, intensive care unit; LMW, low molecular weight.