Adult Respiratory Distress Syndrome

Definition

Adult respiratory distress syndrome (ARDS) is a form of severe lung damage. It is a life-threatening lung condition. ARDS can occur in very ill or severely injured people. It is not a specific disease.

ARDS starts with the tiny blood vessels in the lungs. These vessels leak fluid into the lung sacs. The fluid decreases the ability of the lungs to move oxygen into the body.

ARDS can develop in anyone over the age of 1 year.

Adult Respiratory Distress Syndrome

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Causes

ARDS can be caused by many types of injuries, including:

• Direct injury to the lungs
• Chest trauma, such as a heavy blow
• Aspiration of stomach contents
• Obstructed airways
• High attitude disease
• Tuberculosis
• Oxygen toxicity
• Radiation
• Cardiopulmonary bypass
• Breathing smoke, chemicals, or salt water
• Burns

Indirect injury to the lungs:

• Severe infection
• Massive blood transfusion
• Pneumonia
• Shock
• Burn
• Head trauma
• Severe inflammation of the pancreas—pancreatitis
• Overdoses of alcohol or certain drugs, such as aspirin, cocaine, opioids, phenothiazines, and tricyclic antidepressants

ARDS may occur within few days of a lung or bone marrow transplantation.

Risk Factors

ARDS develops most often in people who are being treated for the conditions listed above. Very few who have these issues will go on to develop ARDS.

ARDS is more common in adults over the age of 65 years. Other factors that may increase your chance of ARDS include:

• Cigarette smoking
• Chronic lung disease

Symptoms

Symptoms often develop within 24-48 hours of the injury. Symptoms begin slowly and worsen with time.

Symptoms may include:

• Shortness of breath
• Fast, labored breathing
• Bluish skin or fingernail color
• Rapid pulse
• Fever
• Chills
• Muscle pain or weakness
• Headache
• Dry Cough

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. People who develop ARDS may be too sick to report their symptoms.

Your bodily fluids and tissues may be tested. This can be done with:

• Blood tests—to look for oxygen levels, evidence of infection, and markers of heart failure
• Swabs from nose and throat for identifying viruses
• Open lung biopsy

Your bodily structures may need to be viewed. This can be done with:

• Chest x-ray
• Echocardiogram
• Bronchoscopy

Pulmonary artery catheterization may also be done to to test heart function.

Treatment

If you are able, talk with the doctor about the best plan for you. Treatment options include the following:

• Treating the underlying cause or injury
• Providing support until the lungs heal:
  • Mechanical ventilation—a machine to help you breathe through a tube placed in the mouth or nose, or through an opening created in the neck
  • Monitoring blood chemistry and fluid levels
  • Oxygen via a face mask or nasal prong

Often, ARDS patients are sedated to tolerate these treatments.

Prevention

To help reduce your chance of getting ARDS, seek timely treatment for any direct or indirect injury to the lungs.