Neuromuscular Blockers In Acute Respiratory Distress Syndrome

Abstract

Acute Respiratory Distress Syndrome (ARDS) is an acute condition characterized by bilateral pulmonary infiltrates and severe hypoxemia in the absence of evidence for cardiogenic pulmonary edema.The etiology of ARDS is either direct injury like aspiration of gastric contents or indirect like sepsis. Pathophysiology of ARDS includes injury to the vascular endothelium or to alveolar epithelium there is a rule to neutrophils,cytokines and positive pressure ventilation.Pathophysiology has 3 stages Inflammatory, Proliferative and Fibrotic. The Laboratory investigations of importance are arterial blood gases, compelete blood count, renal functions, liver functions, brain natriuretic peptide and serum cytokines. Chest X ray is essential for diagnosis,Computed tomography is more sensitive if the patient condition is suitable. Echocardiography also has a role in the diagnosis. The neuromuscular junction is made up of a motor neurone and a motor endplate with a synaptic cleft or junctional gap dividing them. Acetylcholine (Ach) is the neurotransmitter in these synapses. Acetylcholine is synthesised from choline and acetylcoenzyme A in the axoplasm of the cholinergic nerve terminals. The mechanisms of the