What is ARDS (Acute Respiratory Distress Syndrome)?

What is ARDS?

Also known as acute respiratory distress syndrome , ARDS occurs when fluid builds up in the small, elastic air sacs (alveoli) in your lungs. The fluid prevents your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.

Acute respiratory distress syndrome typically occurs in people who are already critically ill or have significant injuries. Severe shortness of breath, the main symptom of ARDS, usually develops within a few hours to a few days after severe injury or infection.

Many people who develop acute respiratory distress syndrome do not survive. The risk of death increases with age and the severity of the disease. Some people who recover from ARDS recover completely, while others have permanent damage to their lungs.

What causes ARDS?

The biological cause of acute respiratory distress syndrome is fluid leaking from the smallest blood vessels in the lungs into the tiny air sacs where blood is oxygenated. Normally, a protective membrane keeps this fluid in the vessels. However, serious illness or injury can damage the membrane, leading to fluid leakage.

The underlying causes of ARDS are:

  • Sepsis: The most common cause of ARDS is sepsis, a serious and common infection of the bloodstream.
  • Inhalation of harmful substances : Inhaling high concentrations of fumes or chemical fumes can result in ARDS.
  • Severe pneumonia: Severe pneumonia usually affects the entire lung.
  • Head, chest, or other major injury: Accidents such as falls or car accidents can directly damage the lungs or the part of the brain that controls breathing.
  • Coronavirus disease 2019 (COVID-19): People with severe COVID-19 may develop ARDS.
  • Other causes: These include pancreatitis (inflammation of the pancreas), major blood transfusions, and burns.
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Who is at risk?

Most people who develop acute respiratory distress syndrome have already been hospitalized for another condition, and many are critically ill. You are particularly at risk if you have a widespread infection (sepsis) in your bloodstream.

People with a history of chronic alcoholism have a higher risk of developing ARDS. They are also more likely to die from ARDS.

What are the symptoms of ARDS?

Symptoms of acute respiratory distress syndrome can vary depending on its cause and severity, as well as the presence of underlying heart or lung disease. General symptoms include:

  • severe shortness of breath
  • Tired and unusually rapid breathing
  • low blood pressure
  • Confusion and extreme tiredness

When to see a doctor?

Acute respiratory distress syndrome often follows a major illness or injury, and most affected people are already hospitalized.

How is ARDS diagnosed?

There is no specific test to identify acute respiratory distress syndrome. Diagnosis is based on physical examination, chest X-ray, and oxygen levels. It is also important to rule out other diseases and conditions (for example, certain heart problems) that may cause similar symptoms.

Imaging tests

Imaging procedures include:

  • Chest X-ray: A chest X-ray can reveal which parts of your lungs and how much fluid is in your lungs, and whether there is a problem with your heart.
  • Computed tomography (CT): A CT scan combines X-ray images taken from many different directions into cross-sectional views of internal organs. CT scans can provide detailed information about structures in the heart and lungs.

lab tests

A test using blood from an artery in your wrist can measure your oxygen levels. Other types of blood tests can check for signs of infection or anemia. If your doctor suspects you have a lung infection, secretions from your airway may be tested to determine the cause of the infection.

heart tests

Because the symptoms of acute respiratory distress syndrome are similar to certain heart problems, your doctor may recommend heart tests such as:

  • Electrocardiogram: This painless test monitors the electrical activity in your heart. It involves attaching several wired sensors to your body.
  • Echocardiogram: A sonogram of the heart, this test can reveal problems with your heart’s structures and function.
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How is ARDS treated?

The first goal in the treatment of acute respiratory distress syndrome is to improve the oxygen levels in your blood. Without oxygen, your organs cannot function properly.

Oxygen therapy

To get more oxygen into your bloodstream, your doctor will likely use:

  • Supplemental oxygen: For milder symptoms or as a temporary measure, oxygen can be given through a tightly fitting mask over your nose and mouth.
  • Mechanical ventilation: Most people with acute respiratory distress syndrome will need the assistance of a machine to breathe. A mechanical breathing device (ventilator) pushes air into your lungs and pushes some of the fluid out of the air sacs.

fluid control

It is very important to carefully manage the amount of intravenous fluid. Too much fluid can increase fluid buildup in the lungs. Too little fluid can strain your heart and other organs and cause shock.

Medication

The goal of drug therapy in people with ARDS usually includes:

  • prevent and treat infections
  • relieve pain and discomfort
  • prevent blood clots in the legs and lungs
  • Minimizing stomach reflux
  • pacify the disease

Lifestyle and home remedies

If you are affected by ARDS, the following suggestions can help protect your lungs:

  • Quit smoking: If you smoke, seek help to quit and avoid secondhand smoke whenever possible.
  • Getting vaccinated: An annual flu shot and a five-year pneumonia shot can reduce your risk of lung infections.

What are the complications of ARDS?

If you have acute respiratory distress syndrome, you may develop other medical problems while in the hospital. The most common problems are:

  • Blood clots : Being hospitalized with a ventilator can increase your risk of developing blood clots, especially in the deep veins in your legs. If a clot forms in your leg, some of it can break off and travel to one or both of your lungs (pulmonary embolism), blocking blood flow.
  • Lung collapse (pneumothorax): In most cases of acute respiratory distress syndrome, a breathing machine called a ventilator is used to increase oxygen in the body and remove fluid from the lungs. However, the ventilator’s pressure and air volume can force gas to pass through a small hole far outside a lung, causing the lung to collapse.
  • Infections : Since the ventilator is attached to a tube inserted directly into your windpipe, it makes it much easier for germs to infect your lungs and cause further damage.
  • Scarring (pulmonary fibrosis): Scarring and thickening of the tissue between the air sacs may occur within a few weeks of the onset of ARDS. This hardens your lungs and makes it more difficult for oxygen to flow from the air sacs into your bloodstream.
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Thanks to improved treatments, more people are recovering from ARDS. However, most survivors end up with potentially serious and sometimes lasting effects such as:

  • Respiratory problems: Many people with acute respiratory distress syndrome recover most of their lung function within a few months to two years, but others may have breathing problems for the rest of their lives. Even people who respond well to treatments often experience shortness of breath and fatigue and may need supplemental oxygen at home for a few months.
  • Depression: Most ARDS survivors also report going through a treatable episode of depression.
  • Problems with memory and clear thinking: Tranquilizers and low blood oxygen levels can lead to memory loss and cognitive problems after ARDS. In some cases the effects may diminish over time, but in others the damage may be permanent.
  • Fatigue and muscle weakness: Being in the hospital and on a ventilator can weaken your muscles. You may feel very tired after the treatment.

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