Overview of Adult Respiratory Distress Syndrome

Overview of Adult Respiratory Distress Syndrome
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What is Adult Respiratory Distress Syndrome?

ARDS is a condition in which the lungs can’t deliver enough oxygen to the blood. Body organs such as the brain and kidneys rely on oxygen-rich blood to function properly. The lungs become inflamed and injury occurs to the capillaries, allowing fluid, blood cells, and proteins to leak into the alveoli. The alveoli look like small clusters of grapes at the end of the airway, and are the primary site of gas exchange in the lungs.

Causes

Most people who get ARDS are in the hospital for other health issues. Critically ill patients in the ICU setting are particularly vulnerable to ARDS. Severe injury or trauma to the body, such as those caused by a motor vehicle accident can set the stage for the development of ARDS. Sepsis, which is bacterial infection in the blood and pneumonia can cause ARDS. Even inhaling smoke or harmful fumes or aspirating on stomach contents can damage the lungs enough to cause ARDS. Other less common causes include:

  • Multiple blood transfusions
  • Near drowning
  • Pancreatitis
  • Adverse reaction to medication
  • Drug overdose, most commonly with heroin
  • Fracture of the long bones such as the femur

Signs and Symptoms

Signs and symptoms can vary depending on the severity of ARDS. Many signs and symptoms are characteristic of other illnesses and include:

  • Low blood pressure
  • Severe shortness of breath
  • Cough or fever
  • Confusion and extreme tiredness
  • Very labored and fast breathing
  • Abnormal breath sounds heard with a stethoscope

Diagnosing

Diagnostic tests include the following:

  • Arterial blood gases which measure the oxygen level in the blood
  • Chest x-ray to reveal fluid in the lungs
  • Basic blood work such as a complete blood count and blood cultures to help determine the cause, such as infection
  • Sputum cultures of fluid coughed up from the lungs
  • Evaluation of breath sounds
  • CT or computed tomography to show more detail of the lungs
  • Bronchoscopy, in which a tiny camera goes down the throat to look inside the airway passages. Samples can also be taken of the lung cells and fluid.

Treatment

Treatment for severe cases includes being placed on a ventilator to support breathing. A ventilator allows tight control of how much oxygen is delivered, the breathing rate, the volume taken in and out, and the pressure at which breaths are delivered. Patients on ventilators have daily arterial blood gases drawn to allow the physician to make needed changes to the ventilator settings.

Fluid intake such as IV fluids must be monitored to avoid more fluid buildup in the lungs. If the ARDS is caused by infection, antibiotics will be given to treat the cause. Anticoagulants may be given to prevent blood clots. Corticosteroids, which reduce lung inflammation, were commonly used to treat ARDS; Some studies have shown that these drugs have no effect on survival rates.

Long Term Prognosis

Although adult respiratory distress syndrome treatment has improved over the last few years, it is still fatal in 25 to 40 percent of all cases. Recovery is a long process and some people may recover completely or continue to have ongoing complications. Shortness of breath, tiredness, depression, and memory problems may occur.

Sources

Mayo Clinic-https://www.mayoclinic.com/health/ards/DS00944

National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html