Description

Acute respiratory distress syndrome (ARDS) occurs when a pulmonary inflammation causes the accumulation of fluid in the small elastic air sacs in the lungs. These air sacs, called alveoli, have a protective membrane, but lung swelling damages of the membrane. The leakage of fluid in the alveoli keeps the lungs from filling with enough air. This means less oxygen reaches the bloodstream, so that the organs of the body does not receive the oxygen they need to function properly.

ARDS usually occurs in people who are already critically ill or have major injuries. People tend to be very short of breath — the main symptom of ARDS — within a couple of hours to a few days after the injury or infection that caused ARDS.

Many people who develop ARDS did not survive. The risk of death increases with age and the severity of the disease. People who survive ARDS, some recover completely. But others have long-lasting lung damage.

Symptoms

The severity of ARDS symptoms can vary, depending on what is the cause of them, and if there are problems of the heart or pulmonary disease. The symptoms include:

  • Severe shortness of breath.
  • Labored and rapid breathing that is not normal.
  • For cough.
  • Discomfort in the chest.
  • Fast heart rate.
  • The confusion and extreme tiredness.

When to see a doctor

ARDS usually follows an injury or illness, and the majority of people who have ARDS are already in a hospital. But if you have symptoms of ARDS and are not in a medical center, go to the nearest emergency department immediately, or call 911 or the local emergency number for help.

Causes

Causes of ARDS include:

  • Sepsis. The most common cause of ARDS is sepsis, a severe and widespread infection of the bloodstream.
  • Severe pneumonia. Severe cases of pneumonia usually affect all five lobes of the lungs.
  • Coronavirus disease 2019 (COVID-19). People who have serious COVID-19 may get ARDS. Because COVID-19 mainly affects the respiratory system, can cause lung injury and inflammation which can lead to COVID-19-related ARDS.
  • The head, chest, or other major injury. Accidents, such as falls or auto accidents can damage the lungs or the part of the brain that controls breathing.
  • The breathing of harmful substances. Breathing in a large amount of smoke or chemical fumes can result in ARDS, as can breathing in vomit. Breathing in the water, in the cases of near drowning can also cause ARDS.
  • Other conditions and treatments. Inflammation of the pancreas (pancreatitis), massive blood transfusions and severe burns can lead to ARDS.

Risk factors

The majority of people who get ARDS is already in a hospital because of another illness. Many are critically ill. People are especially at risk if you have an infection, such as sepsis or pneumonia. They are also at higher risk if they have COVID-19, especially if you also have metabolic syndrome.

People who have alcohol use disorder, or use recreational drugs or smoke lifestyle habits that can cause damage to the lungs, are at increased risk of developing ARDS. Have a history of alcohol, drug or tobacco use also increases the risk of ARDS.

Complications

ARDS can lead to other health problems, while at the hospital, including:

  • The blood clots. The lie that's still in the hospital while you are connected to a respirator can make it more likely that you're going to get blood clots, especially in the deep veins of the legs. If a blood clot forms in the leg, a part of it can break off and travel to one or both lungs, where it can block the flow of blood. This is called a pulmonary embolism.
  • A collapsed lung, also called a pneumothorax. In the majority of people with ARDS, a breathing machine called a ventilator brings more oxygen into the body and forces fluid out of the lungs. But the pressure and the volume of air the fan can be the force the gas to go through a small hole in the outside of the lungs and cause lung collapse.
  • Infections. A fan connected to a tube inserted in the windpipe. This makes it much easier for germs to infect and damage your lungs.
  • Scars and damages the lungs, known as pulmonary fibrosis. The scarring and thickening of the tissue between the air sacs in the lungs can occur within a couple of weeks of the onset of ARDS. This makes the lungs more rigid, and it is even more difficult for the oxygen to flow from the air sacs into the bloodstream.
  • Stress ulcers. The more acid in the stomach due to a serious illness or injury can irritate the stomach lining and cause ulcers.

Thanks to improved treatments, more people are surviving ARDS. But many of the survivors end up with potentially serious and sometimes long-lasting effects:

  • Breathing problems. After having ARDS, many people get the majority of your lung function back within several months to several years, but others may have trouble breathing for the rest of their lives. Even people who do well tend to have difficulty breathing, and fatigue and may need additional oxygen at home for a couple of months.
  • Depression. The majority of ARDS survivors also report going through a period of depression, which can be treated.
  • Problems with memory and thinking clearly. Sedatives and low levels of oxygen in the blood, which can lead to memory loss and learning problems after ARDS. In some people, the effects can be improved over time. But in others, the damage can last for the rest of their lives.
  • Fatigue and muscle weakness. Being in the hospital and on a ventilator can cause your muscles to weaken. You may also feel very tired after the treatment.

Diagnosis

There is not a specific test for ARDS. The professional of the health of your diagnosis on the basis of physical examinations, chest x-rays and oxygen levels. It is also important to rule out other diseases and conditions, such as certain heart problems that can cause similar symptoms.

Images

A chest x-ray can show what parts of their lungs, and how much of the lungs have fluid in them and if your heart has grown bigger. Another test called a ct scan combines X-ray images taken from many directions, and creates a cross-section of the internal organs. The ct scan can give detailed information about the structures inside the heart and the lungs.

Laboratory tests

A test with blood from an artery can measure your oxygen level. Other types of blood tests can check for the symptoms of the infection or other medical conditions. If your healthcare provider thinks you have an infection in the lungs, the airway secretions can be tested to find the cause of the infection.

Heart tests

Because the symptoms of ARDS are like those of some heart problems, your healthcare provider may recommend tests to the heart, such as:

  • The electrocardiogram. This painless test, which is also known as ECG, monitors the electrical activity of your heart. During the test, a health care professional joins multiple wired sensors of your body.
  • The echocardiogram. This test uses sound waves to create images of the heart. It is shown how the blood moves through the heart chambers and heart valves, and if there are changes in the structures of your heart.

Treatment

The first goal in the treatment of ARDS is to improve the oxygen levels in the blood. Without oxygen, your organs can't function properly.

Oxygen

To get more oxygen in your bloodstream, your health care professional's likely that you are going to use:

  • Extra oxygen. For milder symptoms, or as a short-term treatment, oxygen can be delivered through a mask that fits tightly around the nose and mouth.
  • Mechanical ventilation. The majority of people with ARDS need the help of a breathing machine. A mechanical ventilator pushes air into your lungs and forces of a little bit of liquid out of the air sacs.

Extracorporeal membrane oxygenation (ECMO)

ECMO may be an option for severe ARDS when other treatment options, such as mechanical ventilation, do not work. ECMO takes over for the heart, lungs, or both, for a limited time, while the lungs to rest and heal. This treatment can help when the body is not able to provide the tissues with enough oxygen.

The ECMO machine is an artificial heart and lung, removing blood from the body through the tubes and the pump of blood through the artificial lung. This process removes carbon dioxide and adds oxygen. Then, the machine pumps the blood in the body. Because of the risks involved, it is important to discuss the pros and cons of ECMO with your health care team.

The prone position

For some people with ARDS, the positioning in the stomach — what is known as the prone position during mechanical ventilation can do more oxygen to the lungs.

Fluids

Carefully manage the amount of IV fluids given to people with ARDS is very important. Giving too much fluid can cause more accumulation of fluid in the lungs. Giving too little fluid can force your heart and other organs, which leads to the download.

Medicine

People with ARDS usually get medicine to:

  • Prevent and treat infections.
  • Relieve the pain and discomfort.
  • Prevent blood clots in the legs and lungs.
  • To reduce the reflux of gastric acid as much as possible.
  • Help them feel calm or less anxious.

Lung transplant

When other treatments do not help, lung transplantation may be an option for some carefully selected people who have ARDS. Usually, these are people who were healthy before developing severe ARDS. Because the lung transplant is a difficult process, which should be done in a center that is highly qualified, experienced surgeons and transplant teams.

Lifestyle and home remedies

If you are recovering from ARDS, these tips can help protect your lungs:

  • Stop smoking. If you smoke, get help to quit smoking. In addition, stay away from second-hand smoke whenever he could.
  • Get vaccinated. The spread of the flu, also called influenza, " the flu each year, as well as the pneumonia vaccine with the recommended frequency, you can reduce your risk of lung infections.
  • Attend pulmonary rehabilitation. Many medical centers now offer pulmonary rehabilitation programs that include exercise, education and counseling to help you learn how to get back to their normal activities and to reach their ideal weight.

Coping and support

The recovery of ARDS can take time, and it is likely that you need a lot of support. Despite the recovery of each person is different, being aware of the common challenges that other, with the condition have had may help.

Keep these tips in mind:

  • Ask for help. Make sure you have help with the daily tasks until you know what you can do on your own. This is particularly important when you come home from the hospital.
  • Join a support group. There are support groups for people of all life with lung problems. Find out what is available in your community or on-line, and consider the possibility of joining with others with similar experiences.
  • Seek professional help. If you have symptoms of depression, such as hopelessness and loss of interest in their usual activities, tell your health care professional or contact a mental health professional. Depression is common in people who have had ARDS, and the treatment can help.
Symptoms and treatment of ARDS