Case Study: Acute Respiratory Distress Syndrome (ARDS)

Case Study: Acute Respiratory Distress Syndrome (ARDS) NUR 401 Scenario: Rocky is a 56 y.o. aeronautical scientist who was involved in a motor vehicle crash (MVC). He was the driver of a vehicle that was hit head-on, pinning him behind the steering wheel. The airbag deployed. He was intubated on scene by pre-hospital personnel and air lifted to a Level I Trauma Center. In the emergency department (ED) the trauma examination and work up revealed bilateral flail chest, right hemopneumothorax, splenic laceration, liver laceration, open fracture to the right tibula-fibula and probable cardiac contusion. He was quickly transferred from the ED to the operating theatre (OR) for repair of his injuries. In the OR he received 36 units of packed red blood cells (PRBCs) 20 units of platelets, 12 units of fresh frozen plasma (FFP), and 18 liters of lactated Ringer’s solution. Post-operatively he was taken to the Surgical-Trauma ICU for recovery and continued care. In the ICU, Rocky’s pulmonary status continued to require higher levels of mechanical support and higher levels of oxygen (FiO2). His daily chest radiograph (CXR), continued to worsen with the latest read being bilateral lung opacities, consistent with acute respiratory distress syndrome (ARDS). 1. What is ARDS? Is a systemic process that is considered to be the pulmonary manifestation of Mods. It is characterized by non­cardiac pulmonary edema and disruption of the alveolar­ capillary membrane as a result of injury to either the pulmonary vasculature or the airways 2. What are the risk factors for developing ARDS? Which does Rocky have?