Medicine and Health Sciences Commons^™

The Psychological Impact Of An Intensive Care Admission On Survivors Of Acute Respiratory Distress Syndrome And Covid-19 Ards, Leah K. Shinn

Honors Undergraduate Theses

Background:

With the COVID-19 pandemic, there has been an influx of patients with acute respiratory distress syndrome (ARDS), an inflammatory lung condition. ARDS survivors are at high risk for developing post-traumatic stress disorder (PTSD) due to intensive care unit (ICU) medical treatments/procedures. They are known to have traumatic memories triggered by their sensorium months to years after being discharged from the ICU. One study found that 23% of ARDS survivors experienced long-term PTSD symptoms 2-3 years after hospital discharge (Bienvenu et al., 2018). Unknown is whether there are similarities in the memories and sensory triggers of PTSD amongst ARDS and …

A Multi-Modal Strategy To Activate Pronation For Acute Respiratory Distress Syndrome Patients, Meredith Mccrorie

Doctor of Nursing Practice Projects

Background: Acute Respiratory Distress Syndrome (ARDS) is an acute pulmonary process that compromises the health of patients in the Intensive Care Unit (ICU). ARDS can progress to irreversible fibrosis causing the lungs to become noncompliant, adversely affecting ventilation or gas exchange (Buckley et al., 2019). An ARDS diagnosis accounts for 30-40% mortality rate which is an improvement from 60% in the last two decades. The clinical course of this disease is highlighted by Acute Hypoxic Respiratory Failure (AHRF) evidenced by chest radiographs revealing bilateral dense consolidations. Manual pronation of ARDS patients has shown an increase in alveolar function with end …

Role Of Bmi1 In Acute Lung Injury, María Helena Hernández-Cuervo

USF Tampa Graduate Theses and Dissertations

Acute Lung Injury (ALI) is a set of signs and symptoms that lead to acute hypoxemic respiratory failure characterized by bilateral pulmonary infiltrates not attributed to cardiogenic origin. It is caused by a massive innate immune response, with the migration of white blood cells (neutrophils and macrophages principally) and a cytokine storm, followed by alterations in mitochondrial function, increase in reactive oxygen species production, and oxidative stress that in turn induces more mitochondrial damage. Several studies have shown that mitochondrial alterations are key events in the mechanism of ALI and reducing mitochondrial dysfunction could be a possible target in the …

Prolonged Prone Positioning For Covid-19-Induced Acute Respiratory Distress Syndrome: A Randomized Pilot Study, David Brian Page

All ETDs from UAB

ationale: Prone positioning is one of the few interventions shown in a robust, randomized, controlled clinical trial to reduce mortality in severe ARDS. Ideal duration of prone positioning is unknown. A 16-hour prone positioning period has been studied and is considered standard, although longer duration may be beneficial. Objectives: Determine if a prolonged prone positioning strategy for patients with COVID-19-induced ARDS is feasible and safe. Methods: We performed a pilot, randomized, parallel-arm feasibility study in patients with COVID-19-induced ARDS. Patients were randomized to either a prolonged 24-hour or a traditional 16-hour prone positioning strategy. Measurements & Main Results: 52 patients …

Therapeutic Approaches For Respiratory Distress Syndrome, Franck J. Kamga Gninzeko

Theses and Dissertations

Respiratory distress syndrome (RDS) is characterized by shortness of breath and low oxygen levels. RDS affects the neonatal and adult populations. In the neonatal population, RDS can be classified as NRDS (Neonatal respiratory distress syndrome), while in adults, it is known as ARDS (acute respiratory distress syndrome). This dissertation examines a therapeutic approach to NRDS and a mechanistic approach to ARDS with in vivo and in vitro models of lung injury. NRDS is characterized by a deficiency or lack of surfactant. Surfactant is an essential compound composed of phospholipids and proteins to prevent the lungs from collapsing. There are several …

Acute Respiratory Distress Syndrome, Amanda Kleinfelder

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by damage in the lungs leading to persistent hypoxemia. The alveoli in the lungs become filled with fluid from damage to the pulmonary capillaries due to inflammatory mediators. The buildup of fluid in the lungs ultimately result in intubation of the patient and mechanical ventilation (Senapathi et al., 2020). ARDS has become more prevalent today with the 2020 Covid-19 pandemic affecting 200 countries resulting is 1.1 million deaths so far (Weiss et al., 2021). Multiple therapies exist for the management of ARDS including prone positioning, deep sedation, and mechanical ventilation …

Acute Respiratory Distress Syndrome, Eric Boyer

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is an inflammatory response that is accompanied by poor diffusion of oxygen across the alveolar-capillary membrane. Unfortunately, ARDS has a high mortality rate close to 43% when suffering from serve ARDS. ARDS cases in the United States range from 64.2 to 78.9 cases per 100,000 people. Early symptoms of ARDS are subtle and are common in many diseases processes. Such symptoms are tachycardia, tachypnea, and dyspnea. Late symptoms are right-sided heart failure, pulmonary hypertension, hypercarbia, and cyanosis. Common triggers of ARDS are sepsis, pulmonary insults such as pneumonia, pancreatitis, trauma, drug overdoses, and blood transfusions. …

Machine Learning Applied To Colloidal Properties Of Perfluorocarbon Nanoemulsions For Imaging In Ards/Ali, Marco Hosfeld

Electronic Theses and Dissertations

Acute Respiratory distress Syndrome (ARDS) and Acute Lung Injury (ALI) are inflammatory lung pathologies consisting of non-hydrostatic pulmonary edema leading to hypoxia and impaired gas exchange in the lungs. ARDS/ALI is both difficult to study and treat as it is not in itself a specific pathology but rather a syndrome consisting of many pathologies that vary case by case. It is, however, consistently characterized by an explosive acute inflammatory response in the lung parenchyma leading to hypoxia. Although time has seen to an increase in the understanding of ARDS/ALI, the mortality rate remains in the range of 30-50%. For these …

The Pathophysiology Of Acute Respiratory Distress Syndrome (Ards), Alyscia Defrancisco

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome (ARDS) is fatal when not recognized early, nursing care can have a positive impact on patient outcomes. ARDS is a disease of the lung caused by an acute lung injury. ARDS accounts for 10-15% of ICU admission and is underrecognized. Key nursing consideration are essential to help identify and treat ARDS.

Acute Respiratory Distress Syndrome, Caroline Bedinghaus

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a complex disease discussed in the following poster. ARDS is an inflammatory disease with a high mortality rate, making it a topic of high interest. Numerous different diseases can initiate ARDS, but not everyone who develops one of those diseases goes into ARDS. The inflammatory response within the lungs causes refractory hypoxemia and shunting. Treatments available for ARDS is mechanical ventilation with smaller tidal volumes, prone positioning, and neuromuscular blocking agents. Nurses caring for these critically ill patients must have an understanding of the overall picture of ARDS, while continuously assessing for possible complications …

Pathophysiology Of Ards, Brittney Nessle

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a progressive life-threatening disease process, having an occurrence of up to 200,000 cases annually in the United States (Schreiber, 2018). The definition of ARDS has changed throughout the years. In 2011, the European Society of Intensive Care Medicine officially proposed the now adopted Berlin ARDS definition. The components within the definition include timing, chest radiography, the origin of edema, and severity of hypoxemia (Modrykamien & Gupta, 2015). There are over 50 different conditions that result in injury to the alveolar-capillary membrane that can lead to ARDS and produce several severe complications, including death. The …

Acute Respiratory Distress Syndrome, Amelia Morgan

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a devastating form of hypoxemic respiratory failure with the potential for significant morbidity and mortality (Dalmedico, et al., 2017). Though the exact cause or trigger for ARDS is not always identified, great strides have been made in its identification and treatment since the 1990’s. Strategies include screening in the emergency department, prone positioning, and lung protective ventilator settings. Knowledge of the pathophysiological processes and familiarity with treatment strategies will aid the practitioner in the decision-making process for these critically ill patients.

Acute Respiratory Distress Syndrome, Allison Bruce

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome (ARDS) burdens intensive care units (ICU) and their patients across the world. This presentation discusses the presentation, pathophysiology, current treatment and nursing implications for ARDS. This pathophysiological process requires exceptional interprofessional teamwork by the healthcare team. It is important for nurses to have an in-depth comprehension of this disease and its manifestations so that it can be detected and treated as quickly as possible. Further research and education are needed to improve the mortality rates of patients with ARDS.

Prone Positioning In Acute Respiratory Distress Syndrome Patients, Sarah Rose H. Thornton

Honors Undergraduate Theses

Introduction: Acute respiratory distress syndrome (ARDS), seen in critically ill patients, is a disease process that affects the lungs and directly impacts a patient’s oxygenation. Despite treatment, patients often die of ARDS secondary to systemic complications. Prone positioning has been introduced as a treatment to improve the outcomes of ARDS patients. This thesis summarized and critiqued recent literature on the outcomes of prone positioning in ARDS patients.

Methodology: An initial literature search was conducted using CINAHL Plus with Text, Medline, Cochrane Database of Systematic Reviews, and US National Library of Medicine National Institutes of Health. Multiple search terms …

Ards Pathophysiology, Kyle Kocher

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a very prevalent disease process in intensive care units around the world. It is estimated that the incidence of ARDS is 75 cases per 100,000 people in the United States (Balaan, Bihler, & Yadam, 2016). It is described as a refractory hypoxemia with pulmonary edema from a noncardiogenic cause (Balaan et al., 2016). The definition of acute respiratory distress syndrome itself has been debated and changed many times throughout the years. The most recently adopted definition of ARDS is the Berlin definition which uses several components to describe the disease. These components included timing …

Ards Pathophysiology, Lisa K. Bowman

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a condition that involves severe injury to the lung and was first identified during the Vietnam War. Continual research has been performed which has led to multiple treatment modalities. Some treatment modalities are viewed as controversial which proves that more research regarding ARDS needs completed in order to improve patient outcomes. Further education and investment in bedside interventions will continue to improve the clinical treatment and survival rates of affected patients.

Activation Of Ampk To Diminish Sepsis-Induced Lung Injury, Nathaniel Bone

All ETDs from UAB

Sepsis is the most frequent cause of death of hospitalized patients in modern ICUs. Severe infection, trauma, hemorrhage, burns, and surgery are significant causes of multi-organ injury and immune dysfunction that in turn primes for a high risk of secondary lung infections. In addition to detrimental inflammation, sepsis is linked to loss of metabolic plasticity due to mitochondrial dysfunction in immune cells and lung tissue. In particular, mitochondrial failure in lungs of critically ill septic patients is correlated with high mortality rates. We proposed that AMP-activated protein kinase (AMPK) activation, a major bioenergetic sensor and metabolic regulator, is a plausible …

Acute Respiratory Distress Syndrome, Jessica L. Kaufman

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is defined as lung failure with a ratio of partial pressure oxygen (PaO2) to fraction of inspired oxygen (FiO2) <100 (Michaels, Hill, Long, Young, Sperley, Shanks, & Morgan, 2013). ARDS is characterized by acute, widespread pulmonary inflammation due to infection (viral or bacterial), trauma, and/or inhaled toxins (Aokage, Palmer, Ichiba, & Takeda, 2015). Approximately 150,000 patients are diagnosed with ARDS each year in the U.S. with reported mortality rates varying from 20%-40% (Butt, Kurdowska, & Allen, 2016; Drahnak & Custer, 2015). The pathophysiology of acute respiratory syndrome is complex, and can result from a number of different insults. Acute respiratory distress syndrome is a life threatening condition that requires aggressive treatment with close monitoring. Successful treatment of ARDS requires expert knowledge from physicians, advanced practice nurses, bedside nurses, and respiratory therapists; all of whom must understand the complex underlying pathophysiology and critical nature of this condition.

Acute Respiratory Distress Syndrome, Jessica A. Bernhard

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a severe respiratory ailment that is a chief cause of mortality for patients in the Intensive Care Unit (ICU) (Gibbons, 2015). ARDS involves the rapid development of respiratory failure resulting from various diseases or injuries to the lungs. Because it includes both short and long term complications, early detection of ARDS is beneficial to prevent its devastating course. Often, these patients have various diseases and injuries which make it difficult to determine the appropriate therapy. Most therapies aim to enhance oxygenation. Some of the interventions include low tidal volume mechanical ventilation and placing the …

Acute Respiratory Distress Syndrome, Brian Flowers

Nursing Student Class Projects (Formerly MSN)

In healthcare, there are many interesting and intriguing conditions that are vital to understand from both a clinical and a pathophysiological standpoint. Comprehending and knowing how to treat these conditions effectively, ultimately leads to the best care and patient outcomes. As a current critical care nurse and future advanced practice nurse, it was important to select a research topic of interest to explore that would benefit a high risk group of patients. Based on this precedent, acute respiratory distress syndrome (ARDS) was chosen. As a critical care nurse, exposure to respiratory conditions and mechanical ventilation management is something nurses are …

Acute Respiratory Distress Syndrome, Jaqueline Yunker

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome is an inflammatory response resulting from injury to the alveolar-­‐capillary membrane. This injury is caused by a systemic inflammatory response that involves either direct trauma to the lung cells, such as a pneumonia, or indirect, such as sepsis. The inflammatory response that is triggered results in leaky alveolar-­‐capillary beds and infiltration of the lungs (Villar, 2011). This is very common with approximately 150,000 cases annually in the United States and a very high mortality rate of 60,000 deaths per year (Pipeling & Fan, 2010). Despite the high mortality rate, 15-­‐35%, there is no set of guidelines …

Comparison Of Albuterol Delivery Between High Frequency Oscillatory Ventilation And Conventional Mechanical Ventilation In A Simulated Adult Lung Model Using Different Compliance Levels, Waleed A. Alzahrani

Respiratory Therapy Theses

COMPARISON OF ALBUTEROL DELIVERY BETWEEN HIGH FREQUENCY OSCILLATORY VENTILATION AND CONVENTIONAL MECHANICAL VENTILATION IN A SIMULATED ADULT LUNG MODEL USING DIFFERENT COMPLIANCE LEVELS By Waleed A. Alzahrani, BSRT BACKGROUND: Delivery of aerosol by pMDI has been described with conventional mechanical ventilation (CMV) but not with high frequency oscillatory ventilation (HFOV). The purpose of this study was to compare aerosol delivery to a simulated 75 kg adult with low compliance during both CMV and HFOV. Since actuation of pMDI with inspiration is not feasible with HFOV, we investigated the impact of actuation timing only during CMV. METHOD: CMV (Respironics Esprit) and …