Medical Critical Care Issues Flashcards

A comprehensive set of vocabulary flashcards covering ARDS, ventilator-associated events, HIE, and other urgent medical conditions like sepsis and drug overdoses.

Acute Respiratory Distress Syndrome (ARDS)

A clinical condition characterized by bilateral opacities on a chest radiograph and respiratory symptoms appearing within 1 week, not fully explained by cardiac failure or fluid overload.

Exudative phase

The initial phase of ARDS involving the leakage of fluid and cells out of pulmonary capillaries and into the lungs.

Type II alveolar cells

Specific cells in the lungs responsible for producing surfactant, which are damaged during the flooding of the lung parenchyma in ARDS.

Heterogeneous pulmonary disease

A unique and difficult-to-manage characteristic of ARDS where the normal lung parenchyma is a smaller portion of the lungs and is highly compliant.

Volutrauma

Pulmonary injury caused by the overdistension of the lungs during mechanical ventilation.

Barotrauma

Pulmonary injury resulting from the application of pressure during mechanical ventilation, potentially leading to a pneumothorax.

Atelectrauma

Pulmonary injury caused by shear forces from the repetitive opening and closing of alveolar units that collapse on exhalation.

Ventilator-associated conditions (VAC)

Tier 1 of VAEs, defined as at least 2 days of clinical stability followed by at least 2 days of worsening oxygenation indicated by a PEEP increase of $\geq 3\,cm\,H_2O$ or $FiO_2$ increase of $\geq 20\%$.

Infection-related ventilator-associated complications (IVAC)

Tier 2 of VAEs, occurring when a VAC is accompanied by abnormal white blood cell counts ($\leq 4,000$ or $\geq 12,000\,cells/mm^3$) or temperature ($< 36\,^{\circ}C$ or $> 38\,^{\circ}C$) and new antimicrobial use for at least 4 days.

Possible ventilator-associated pneumonia (PVAP)

Tier 3 of VAEs, characterized by evidence of IVAC plus the presence of purulent secretions or positive respiratory cultures.

Ventilator-associated tracheobronchitis (VAT)

A condition involving mechanical ventilation for $> 48\,hours$ with positive respiratory cultures obtained by bronchoalveolar lavage but no new radiographic infiltrates.

Hypoxic Ischemic Encephalopathy (HIE)

An acute brain injury caused by a severe or prolonged lack of oxygen, which can be caused by conditions such as sepsis, cardiac arrest, or drowning in adults.

Cerebral perfusion pressure (CPP)

The net pressure gradient required to provide blood flow to the brain, calculated by the formula $CPP = MAP - ICP$.

Sepsis

A life-threatening emergency involving a systemic response triggered by infection, often characterized by elevated serum lactate levels indicating tissue hypoxia.

Acute hepatic failure

An emergent condition with poor prognosis characterized by jaundice, hepatomegaly, and elevated aminotransferase levels, often assessed using the MELD score.

Acute renal failure

A rapid decline in renal function where renal cell death can occur at a systolic pressure of $< 75\,mm\,Hg$.

Oral N-acetylcysteine (NAC)

Commonly known as Mucomyst, this is the antidote for acetaminophen overdose and is most effective if administered within 8 hours of ingestion.

Naloxone (Narcan)

The management agent for opioid overdose, administered in doses of $0.2$ to $2\,mg\,IV$, with multiple doses often required for fentanyl or codeine.

Ischemic Stroke

A disturbance of blood flow to an area of the brain due to a clot, managed by therapies like tPA (thrombolytic) and cerebral arterial thrombectomy.

Subdural hematoma (SDH)

A type of hemorrhagic stroke caused by a ruptured cerebral aneurysm resulting in bleeding into the subarachnoid space.

Pulmonary venous thromboembolism

A thrombus in the pulmonary circulation that can result in tachypnea, dyspnea, and respiratory alkalosis.