Adult Respiratory Distress Syndrome

Definition

Acute respiratory distress syndrome (ARDS) is a form of severe lung damage. It happens in people who are very ill or hurt. Most people will be under care in a hospital. It can cause death.

ARDS

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Causes

ARDS is caused by small blood vessels that leak fluid into the small air sacs of the lungs. The fluid in the sacs blocks oxygen from passing into the body. ARDS may be caused by direct injury.

This can happen in people with:

• Pneumonia
• Sepsis of the lungs
• Breathing regurgitated stomach matter
• A bruise of the lung
• Near-drowning
• Breathing smoke or certain chemicals
• Respiratory syncytial virus

Other indirect injuries that may lead to ARDS are:

• Sepsis
• Severe injury, such as a heavy blow to the chest
• Burn
• Swelling of the pancreas
• Drug overdose
• A large blood transfusion

Risk Factors

The health problems above raise your risk of ARDS.

Other things that may raise your risk are:

• Smoking
• Lung disease
• Alcohol abuse

Symptoms

Signs often start within 24 to 48 hours. They will also worsen with time. It may happen slowly or quickly.

You may have:

• Problems breathing
• Rapid heartbeat
• Signs of infection, such as fever or chills
• Bluish skin or fingernail color
• Coughing
• Chest pain
• Confusion

Diagnosis

You will be asked about your symptoms and health history. An exam will be done. If you can’t tell the doctor how you feel, then symptoms and test results will be used.

You will have blood tests. They will look for low oxygen levels, infection, and signs of heart failure .

Pictures will be taken of your chest. This can be done with:

• Chest x-ray
• Echocardiography
• CT scan of chest

Treatment

If you are able, talk with the doctor about the best plan for you. The goals are to:

• Treat the cause
• Help you breathe

Options to help you breathe are:

• Mechanical ventilation —a machine that helps you breathe; air may be delivered through a tube placed in the windpipe or through an opening made in the neck
• Non-invasive mask mechanical ventilation—a mask that goes over the mouth and nose and is held in place with straps
• Oxygen therapy —delivered through a face mask or tube that sits under the nose
• Extracorporeal membrane oxygenation (ECM)—advanced breathing and heart support (not as common)

Medicines may be used to relax you during these treatments. Oxygen and fluid levels will also be watched closely.

Prevention

ARDS can’t be prevented.