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Adult Respiratory Distress Syndrome

(ARDS; Acute Respiratory Distress Syndrome; Non-cardiogenic Pulmonary Edema)

 

Definition

Adult respiratory distress syndrome (ARDS) is a form of severe lung damage. It is a life-threatening lung condition. ARDS occurs in people who are very ill or severely injured. Most will already be under care in a hospital.

Adult Respiratory Distress Syndrome

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Causes    TOP

When oxygen is inhaled it passes through airways to small sacs of your lungs. These sacs are lined with small blood vessels. The oxygen can pass through the sacs and into the blood vessels. The blood will carry it through the body. With ARDS, these blood vessels leak into the lungs sacs. The fluid in the sacs blocks oxygen from passing into the body.

ARDS may be caused by direct injury to lung tissue such as:

  • Pneumonia
  • Pulmonary sepsis
  • Inhaling of stomach contents (Aspiration)
  • Direct injury to the lungs
  • Near-drowning
  • Inhalation of smoke or certain chemicals
  • Reaction to cardiopulmonary bypass circuit

Other conditions that may indirectly lead to ARDS include:

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

 

Risk Factors    TOP

The conditions above are main risk factors for ARDS. Although few with these conditions above will 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
  • Chronic excessive alcohol use
 

Symptoms    TOP

Symptoms often begin within 24 to 48 hours of the injury. They will also worsen with time. It may be a slow or rapid progress.

Symptoms may include:

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

Diagnosis    TOP

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 doctor will make a diagnosis based on your history, symptoms, and the results of tests.

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

  • Blood tests—to look for abnormally low oxygen levels, evidence of infection, and markers of heart failure
  • Swabs from nose and throat—to look for other causes such as viral infections

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

Though rare, the doctor may order a pulmonary artery catheterization. It can show how well the heart is working.

 

Treatment    TOP

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

  • Treat the underlying cause or injury
  • Provide supportive care until lungs have recovered

Options to help improve oxygen levels in the blood while you recover include:

  • Mechanical ventilation—a machine that assists breathing; air may be delivered through a tube placed in the mouth or through an opening created in the neck
  • Non-invasive mask mechanical ventilation—mask sits over the mouth and nose; in rare cases
  • Oxygen therapy—delivered through a face mask or tube that sits under the nose

Sedation may be used to help tolerate these treatments. Oxygen and fluid levels will also be monitored by the medical team.

 

Prevention    TOP

ARDS is not preventable. You may decrease your risk of ARDS if you avoid smoking or alcohol abuse.

RESOURCES:

American Lung Association
http://www.lung.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

The Lung Association
http://www.lung.ca

REFERENCES:

Acute respiratory distress syndrome (ARDS). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113803/Acute-respiratory-distress-syndrome-ARDS. Updated July 27, 2016. Accessed September 26, 2016.

Bosma KJ, Lewis JF. Emerging therapies for treatment of acute lung injury and acute respiratory distress syndrome. Expert Opin Emgerg Drugs. 2007;12(3): 461-477.

Explore ARDS. National Heart, Lung, and Blood Institute website. Available at:
...(Click grey area to select URL)
Updated January 12, 2012. Accessed May 4, 2016.

Jain R, DaiNogare A. Pharmacological therapy for acute respiratory distress syndrome. Mayo Clin Proc. 2006;81(2):205-212.

Understanding ARDS. ARDS Support Center website. Available at:
...(Click grey area to select URL)
Accessed May 4, 2016.



Last reviewed June 2017 by Michael Woods, MD
Last Updated: 4/25/2018

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