ARDS Management ED and Beyond

<p>EMRA*Cast host <strong>Dr. Alex Kaminsky</strong> takes a deep dive on the topic of Acute Respiratory Distress Syndrome (ARDS) with <strong>Dr. Sean Hickey</strong> and <strong>Dr. Evan Leibner</strong>. </p> <p><strong>Host:</strong></p> <ul> <li><span style="font-weight: 400;">Alex Kaminsky MD: PGY-3 UCSF Fresno</span></li> </ul> <p><strong>Guests: </strong></p> <ul> <li><span style="font-weight: 400;">Sean Hickey MD: PGY3 Mt. Sinai Hospital, NYC</span></li> <li><span style="font-weight: 400;">Evan Leibner MD: ED/Crit Care Asst. Prof Mt. Sinai Hospital, NYC</span></li> </ul> <p><strong>Overview:<br /></strong></p> <p><strong>Broad Strokes</strong><span style= "font-weight: 400;">:</span> <em><span style= "font-weight: 400;">ARDS is diffuse interstitial pulmonary edema secondary to increased pulmonary vasculature permeability. This causes a disruption in gas exchange.</span></em></p> <p><strong><em>More precise definition:</em></strong> <span style= "font-weight: 400;">Acute Respiratory Distress Syndrome (ARDS) is an acute diffuse, inflammatory lung injury, leading to increased pulmonary vascular permeability, increased lung weight, and loss of aerated lung tissue with hypoxemia and bilateral radiographic opacities, associated with increased venous admixture, increased physiological dead space and decreased lung compliance.</span></p> <p><span style="font-weight: 400;">Etiology of injury pattern must be from a non-primary cardiopulmonary source.</span></p> <p><strong>Phases of Histologic Patterns:</strong><em><span style= "font-weight: 400;">      </span></em></p> <p><strong>Broad Strokes:</strong> <em><span style= "font-weight: 400;">Histologically in the lungs "diffuse alveolar damage" (DAD)</span></em></p> <p><strong>Initial response to injury</strong><strong>: </strong></p> <p><span style="font-weight: 400;">Exudative phase, immune cell mediated damage to alveoli.</span></p> <p><span style="font-weight: 400;">- Protein rich fluid buildup in the interstitium and alveoli.</span></p> <p><span style="font-wei