Overview Of Acute Respiratory Distress Syndrome (ARDS)
Acute respiratory distress syndrome (ARDS) is a dangerous and life-threatening lung condition. To clarify, it impedes the ability of the lungs to get enough oxygen and deposit that oxygen into the bloodstream. This disease occurs in infants as well as adults.
Commonly Associated With
Noncardiogenic pulmonary edema, Acute lung injury, Wet Lung, and Increased-permeability pulmonary edema
Causes Of Acute Respiratory Distress Syndrome (ARDS)
ARDS can result from any major indirect or direct lung injury.
Other common causes include:
- Pneumonia
- Inhalation of chemicals
- Aspiration (Breathing some foreign substance into the lungs. These substances can include vomit, water, food, or some other material)
- Trauma
- Lung transplant
- Septic shock (widespread infection throughout the body)
Depending on the oxygenation level of the person’s bloodstream and how much oxygen is being exchanged during breathing, the severity of ARDS can be classified as:
- Mild
- Moderate
- Severe
ARDS leads to an eventual buildup of fluid in the alveoli (air sacs) of the lungs. In short, this prevents oxygen from passing into the bloodstream efficiently.
The lungs also become stiff and heavy due to the buildup of fluid. As a result, this decreases their ability to expand properly. With ARDS, the person’s oxygen level can remain dangerously low even with ventilator-assisted oxygen delivery through an endotracheal tube (breathing tube).
ARDS often occurs along with other organ system failures, such as the kidneys or liver. For instance, heavy alcohol use and cigarette smoking are risk factors for developing ARDS.
Symptoms Of Acute Respiratory Distress Syndrome (ARDS)
Symptoms of ARDS typically develop within 24-48 hours after the underlying cause damages the lungs. Often, those with ARDS are too ill to verbally complain of symptoms.
Symptoms may include any of the following:
- Rapid breathing (tachypnea)
- Fast heartbeat (tachycardia)
- Low blood pressure (hypotension) and organ failure
- Shortness of breath
Exams & Tests
When a health care provider listens to the chest with a stethoscope (auscultation), they may hear abnormal breath sounds. For example, crackles can be a sign of fluid in the lungs. Often, the patient’s blood pressure is quite low. It is common to see cyanosis (blue-tinged lips, skin, and nail beds caused by a lack of oxygen in their tissues).
Diagnostic tests for ARDS can include:
- A CT scan or chest x-ray
- Various blood tests, including blood chemistries of several types and a CBC (complete blood count)
- A bronchoscopy in some cases
- Various tests for several types of possible infections
- Urine and blood cultures
- An arterial blood gas test
- Sputum cultures and analysis
In addition, the patient may need an echocardiogram to rule out heart failure, which appears similar to ARDS on a chest x-ray.
Treatment Of Acute Respiratory Distress Syndrome (ARDS)
Patients with ARDS often need to be treated in an intensive care unit (ICU).
Above all, the goal of ARDS treatment is to support the person’s breathing while treating the underlying cause of the ARDS. This treatment can involve medications for infections, medications to reduce inflammation, and medications meant to remove excess fluids from the lungs.
In addition, a ventilator can be used to deliver high doses of needed oxygen and positive pressure to damaged lungs. Those who need ventilators will need to be sedated with various medications before it can be used. During ventilator treatment, health care providers try their best to make sure the lungs are protected from further damage. Until the lungs recover from whatever damage caused the ARDS, most treatment is supportive in nature.
Sometimes, in severe cases, it is possible to do a treatment called extracorporeal membrane oxygenation (ECMO). During ECMO treatment, a machine that removes carbon dioxide and adds oxygen filters the person’s blood.
