Physio in Acute Respiratory Distress Syndrome (ARDS)

[mrunalini_shah]

HI. In ARDS, the best treatment is prone positioning for time patient can tolerate. PEEP is also very helpful.

[smithpai82]

Physio treatment goes according to the pathophysiological stage of ARDS which is multifactorial.

If in the exudative phase (caused due to DAD(Diffuse alveolar damage)), characterizing pulmonary edema, positioning to avoid further V/Q mismatch (prone or lateral - more appropriate wud be prone, recent trend even head end elevated),
ET suction - airway clearance, concomitant ventilatory support (Low Vt, High PEEP strategy, PCV), alveolar recruitment maneuvers, CPAP
Excessive passive movements can lead to further distress, if pt is extremly tachycardic, tachypneic.. Ankle toe and slow movemnts ideal. Monitor ABG

With due reasoning - proceed for the fibroproliferative phase.. - excessive secretion retention - Bronchial hygeine and remodelling phase..

ARDS can lead to ILD due to excess fibrosis in interstitium.. -further rehab..