Acute respiratory distress syndrome, or ARDS, is inflammatory lung damage caused by fluid buildup in the lungs' tiny air sacs (called alveoli). ARDS inhibits the lungs from filling with air and results in dangerously low blood oxygen levels (hypoxemia).
Other organs, including the brain, heart, kidneys, and stomach, are deprived of the oxygen they require to function. ARDS is harmful and can cause a variety of significant and life-threatening complications.
What is the cause of acute respiratory distress syndrome (ARDS)?
Fluid leaks from tiny pulmonary arteries into lung air sacs produce ARDS (alveoli). When the protective membrane between blood arteries and air sacs is damaged, oxygen levels in the blood fall.
ARDS can be caused by a variety of factors, including:
Sepsis: The most prevalent cause of ARDS, is a severe infection in the lungs (pneumonia) or other organs that causes extensive inflammation.
Aspiration pneumonia is caused by the aspiration of stomach contents into the lungs, which can result in serious lung injury and ARDS.
COVID-19 coronavirus: COVID-19 infection can lead to severe ARDS.
Pancreatitis (severe pancreatic inflammation) and extensive blood transfusions
Accidents and falls can cause direct harm to the lungs or other organs in the body, resulting in serious inflammatory injury to the lungs.
Inhalational harm: Breathing and being exposed to excessive levels of chemical fumes or smoke.
Overdose on substances such as cocaine and opiates are examples of drug overdoses.
What are the signs and symptoms of acute respiratory distress syndrome (ARDS)?
ARDS symptoms are determined by the source and severity of the disease, as well as any pre-existing lung or heart issues. Severe shortness of breath or breathlessness is symptoms.
Extreme exhaustion and muscle fatigue
Rapid heart rate.
Because of the low oxygen content in the blood, the fingernails and lips have a bluish color.
Cough, as well as chest pain.
If ARDS is caused by a severe illness (sepsis), sepsis symptoms may be present as well (fever, low blood pressure).
What tests are used to determine the presence of acute respiratory distress syndrome (ARDS)?
A chest X-ray is used to determine the amount of fluid in the lungs.
A blood test to detect the level of oxygen in the blood, which can help identify the severity of ARDS.
An echocardiogram (heart ultrasound) is used to assess heart function.
ARDS symptoms and indications may necessitate extra testing to rule out other reasons that are similar to ARDS.
To obtain thorough information on the lungs, a computed tomography (CT scan) may be performed.
To determine the source of the infection, secretions from the airways may be sampled.
What are the potential complications of acute respiratory distress syndrome (ARDS)?
ARDS complications and issues might arise while a patient is in the hospital or after discharge
Blood clots, also known as deep vein thrombosis.
A lung has collapsed (pneumothorax). This could be due to the ventilator applying pressure to the wounded stiff lungs.
Scarred lungs, also known as lung fibrosis.
Post-traumatic stress disorder (PTSD)
Anxiety and depression are two of the most common symptoms of anxiety and sadness.
ARDS is a potentially fatal disease. However, advances in care and ventilator treatments, such as prone ventilation with patients lying face down to enhance oxygen flow, are allowing more individuals to live and lower the risk of sequelae from ARDS.
Recovery from ARDS can be time-consuming. Most people can be taken off the ventilator and allowed to breathe normally. Some people recover completely, while others may suffer chronic lung difficulties that necessitate the care of a lung specialist (pulmonologists). Some patients may experience post-intensive care syndrome (PICS), as well as a post-traumatic stress disorder, physical weakness, anxiety, and despair.
What is the treatment for acute respiratory distress syndrome (ARDS)?
ARDS is often treated in the intensive care unit (ICU), along with the underlying cause.
Mechanical ventilation (a ventilator) is frequently employed in the care of ARDS patients. In milder cases of ARDS, oxygen may be administered using a fitting face mask or a cannula inserted through the nose.
Steps to reduce problems from ARDS are routinely employed (see below). Sedation for pain management is one of them.
Breathing tests will be performed to determine when it is safe to remove the tube and ventilator.
Blood thinners are used to prevent clots.
Keeping fluid collection in the lungs to a minimum.
Stress ulcers in the stomach can be reduced.
Muscle weakness can be avoided with active mobility and physical therapy.
ARDS Medical Treatment
The first goal of treating ARDS is to improve blood oxygen levels so that organs can function better. Supplemental oxygen is one of three basic techniques to supply additional oxygen. For milder symptoms or as a stopgap solution, oxygen can be administered using a mask that fits snugly over the nose and mouth.
Mechanical ventilation. The majority of persons with ARDS require the assistance of a machine to breathe. A mechanical ventilator drives air into the lungs while also forcing fluid out of the air sacs.
Extracorporeal membrane oxygenation is a type of extracorporeal membrane oxygenation. The blood is withdrawn from the body and oxygenated outside the body before being returned.
ECMO in the treatment of ARDS
Extracorporeal membrane oxygenation (ECMO) refers to a circuit that is located outside the body ("extracorporeal") that directly oxygenates and eliminates carbon dioxide from the blood. ECMO acts as a prosthetic lung, supplementing the failing lungs.
When ECMO is used to treat respiratory failure, a catheter is inserted into a central vein near the heart. A mechanical pump takes blood from the vein into the circuit, where it travels through a membrane (known as an "oxygenator" or "gas exchanger") that serves as an interface between the blood and freshly delivered oxygen.
The blood is warmed or chilled as needed before being returned to a central vein ("veno-venous ECMO") or an artery ("veno-arterial ECMO"). Veno-venous ECMO just offers respiratory support, but veno-arterial ECMO also provides hemodynamic (blood pressure) support. The following are some circumstances in which ECMO may be beneficial:
ECMO may be utilized as salvage therapy in cases of life-threatening acute respiratory insufficiency with significant gas exchange anomalies.
ECMO may also be utilized in people with ARDS who would benefit from lung-protective ventilation but are unable to tolerate it.