Acute respiratory distress syndrome (ARDS)
Make an Appointment
Talk to DoctorOverview
Acute respiratory distress syndrome (ARDS) is a condition characterized by the accumulation of fluid in the small, elastic air sacs (alveoli) within the lungs. Less oxygen enters your circulation because the fluid in alveoli prevents your lungs from filling with enough air. As a result, your organs are deprived of the oxygen they require to function.
Individuals with pre-existing critical illnesses or severe injuries have an increased susceptibility to the development of ARDS. The predominant manifestation of ARDS, characterized by shortness of breath, usually emerges within a few hours to several days subsequent to the initial injury or infection that precipitated its onset.
A significant number of individuals afflicted with ARDS do not survive the condition. The likelihood of mortality is heightened by factors such as advanced age and the severity of the illnesses. For those who do manage to survive ARDS, the outcomes can vary considerably: some individuals experience a complete restoration of their health, while others endure lasting lung impairment that persists throughout their lifetime.
Symptoms
The severity of ARDS’s signs and symptoms might vary depending on the condition’s cause, its severity, and whether or not underlying heart or lung illness is present.
The individual may experience:
- Profound shortness of breath
- Difficult and abnormally fast breathing
- Low blood pressure
- Confusion and extreme fatigue
ARDS (Acute Respiratory Distress Syndrome) typically develops following a severe illness or injury, primarily affecting individuals who are already hospitalized.
Causes
The smallest blood vessels in the lungs leak fluid into the tiny air sacs where the blood is oxygenated, which is the mechanical cause of ARDS. This fluid is typically kept in the vessels by a protective barrier. However, severe disease or injury can harm the membrane, resulting in fluid leakage and ARDS.
ARDS’ underlying causes include:
- Sepsis. Sepsis, a dangerous and widespread bloodstream infection, is the most typical cause of ARDS.
- Head, chest or other major injury. Accidents that cause direct damage to the lungs or the area of the brain that regulates respiration.
- Severe pneumonia. All five lung lobes are typically affected by severe pneumonia instances.
- Coronavirus disease 2019 (COVID-19). Severe COVID-19 patients may experience ARDS.
- Inhalation of harmful substances. As well as inhaling (aspirating) vomit or experiencing a near-drowning episode, breathing in large amounts of smoke or chemical fumes can cause ARDS.
- Others. Burns, heavy blood transfusions, and pancreatitis (pancreas inflammation).
Risk factors
The majority of patients with ARDS are already in the hospital for another illness, and many are in serious condition. If you have sepsis, a widespread infection in your bloodstream, you are especially at danger.
People with a history of chronic alcoholism are at a higher risk of developing ARDS and have an increased likelihood of mortality associated with the condition.
Diagnosis
A specific test for identifying ARDS does not exist. Diagnosis of ARDS is typically established through a combination of physical examination, chest X-ray imaging, and assessment of oxygen levels. Furthermore, it is crucial to exclude other medical conditions and ailments that may present similar symptoms, including certain cardiac disorders, in order to get an accurate diagnosis.
Imaging
- Chest X-ray. The amount of fluid in your lungs, where it is located, and if your heart is enlarged can all be seen on a chest X-ray.
- Computerized Tomography (CT). A CT scan creates cross-sectional pictures of interior organs by combining X-ray images captured from numerous angles. CT scans can give precise details on the internal structures of the heart and lungs.
Lab tests
Your level of oxygen can be determined through a test utilizing blood from an artery in your wrist. Other blood tests can look for indicators of anemia or an infection. Secretions from your airway may be analyzed to identify the infection’s origin if your doctor suspects you have a lung infection.
Heart tests
Your doctor may recommend undergoing heart tests listed below because the symptoms of ARDS can resemble those of certain heart conditions:
- Electrocardiogram. The heart’s electrical activity is monitored during this painless examination. A number of hooked sensors are attached to your body in this process.
- Echocardiogram. This test, a cardiac ultrasonography, can identify issues with the structure and operation of your heart.
Treatment
Improving blood oxygen levels is the first crucial step in the treatment of ARDS. Without sufficient oxygen, proper functioning of your organs becomes compromised.
Oxygen
To increase the amount of oxygen in your bloodstream, your doctor is likely to employ the following methods:
- Supplemental oxygen. Through a mask that snugly covers your nose and mouth, oxygen may be administered for less severe symptoms or as a temporary solution.
- Mechanical ventilation. The majority of ARDS patients will need mechanical breathing assistance. While pumping air into your lungs, a mechanical ventilator forces some of the fluid out of the air sacs.
Fluids
Managing intravenous fluid levels is of utmost importance in ARDS treatment. Excessive fluid retention can exacerbate lung congestion, potentially worsening the condition. Conversely, inadequate fluid balance can lead to stress and shock in vital organs, including the heart. Striking the right balance is crucial to ensure optimal outcomes.
Medication
Medication is typically given to people with ARDS to:
- Prevent pulmonary and leg blood clots.
- Treat infections and prevent them.
- Sedate
- Manage pain, and discomfort.
- Reduce gastric reflux
