Acute Respiratory Distress Syndrome

ExitCare ImageAcute respiratory distress syndrome (ARDS) is a serious, life-threatening lung condition that can cause breathing failure. It occurs in people who are critically ill or in people who have had a serious injury.

CAUSES

ARDS occurs when small blood vessels in the lungs leak fluid into the air sacs (alveoli) of the lungs. The fluid causes the lungs to become "stiff" and decreases the lungs' ability to inflate. The fluid also prevents oxygen from being absorbed into the bloodstream. When the bloodstream does not have enough oxygen, the body's vital organs do not get enough oxygen to function properly. ARDS can occur in the following conditions:

  • Sepsis. This is a serious bloodstream infection.

  • Serious injury (trauma) to the head or chest.

  • Pneumonia.

  • After major surgery, such as a lung transplant.

  • Drug overdose.

  • Breathing (inhalation) of harmful chemicals.

SYMPTOMS

ARDS comes on quickly (rapid onset) and can occur within 24 to 48 hours of an infection, illness, surgery, or injury. Symptoms include:

  • Shortness of breath or difficulty breathing.

  • Cyanosis. This is a bluish color to the skin or nailbeds (due to low oxygen levels in the blood).

  • Fast or irregular heart rate.

  • Low blood pressure (hypotension).

  • Organ failure.

DIAGNOSIS

There is not a specific test to diagnose ARDS. It is usually diagnosed when other diseases and conditions that cause similar symtpoms have been ruled out. When a person is thought to have ARDS, the following tests may be performed:

  • A chest X-ray or computed tomography (CT) scan to look at the lungs.

  • Arterial blood gas (ABG) analysis. This test looks at the oxygen level in the blood.

  • Blood tests to rule out infection.

  • Sputum culture to rule out a lung infection.

  • Bronchoscopy.

TREATMENT

ARDS is a critical condition. People who develop ARDS need to be in a hospital intensive care unit (ICU). Treatment of ARDS includes:

  • Providing oxygenation. This is a main treatment goal of ARDS. A breathing machine (ventilator) is often used to help a person breathe and to provide oxygen. When on a breathing machine, medicine is given to keep patients asleep (sedated).

  • Treatment of the underlying cause of ARDS (infection, illness, or trauma).

  • Supportive treatment such as:

  • Intravenous (IV) fluids.

  • Liquid nutrition that goes through an IV or feeding tube.

  • Blood pressure medicine to support low blood pressure.

  • Antibiotic medicine to help fight infection.

  • Steroid medicine to help decrease swelling (inflammation) in the lungs.

  • Diuretic medicine to get rid of extra fluid in the body.

HOME CARE INSTRUCTIONS

After recovering from ARDS, you may have weakness, shortness of breath, or memory problems. You may also suffer from depression or from complications of the illness that caused ARDS. You can do several things to help your recovery:

  • Do not smoke.

  • If you drink alcohol, limit the amount of alcohol you drink to 1 or 2 drinks a day.

  • Be sure you get a yearly flu (influenza) shot. You should get a pneumonia vaccine once every 5 years.

  • Ask your caregiver about lung rehabilitation programs.

  • Ask your caregiver about local support groups for people with breathing problems.

  • Ask friends and family to help you if daily activities make you tired.

SEEK MEDICAL CARE IF:

  • You become short of breath with activity or while at rest.

  • You develop a cough that does not go away.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have sudden shortness of breath with or without chest pain.

  • You have chest pain that does not go away.

  • You develop swelling or pain in one of your legs.

  • You have trauma to your chest or any other part of your body.

  • You have a fever.

  • You overdose or have a reaction to your medicine.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.