Acute Respiratory Distress Syndrome
(ARDS; Adult Respiratory Distress Syndrome; Non-cardiogenic Pulmonary Edema)
Definition
Acute respiratory distress syndrome (ARDS) is a form of severe lung damage. It happens in people who are very ill or hurt. It can be deadly.
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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.
Direct injuries that may lead to ARDS are:
- Pneumonia
- Sepsis of the lungs
- Breathing regurgitated stomach matter
- A bruise of the lung
- Near-drowning
- Breathing smoke or certain chemicals
- Respiratory syncytial virus
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 the risk of ARDS.
Other things that may raise the risk are:
- Smoking
- Lung disease
- Alcohol use disorder
Symptoms
Signs often start within 24 to 48 hours. They will also worsen with time. It may happen slowly or quickly.
A person may have:
- Problems breathing
- Rapid heartbeat
- Signs of infection, such as fever or chills
- Bluish skin or fingernail color
- Coughing
- Chest pain
- Confusion
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. Tests will be done if you are not able to communicate.
Blood tests will be done to look for low oxygen levels, infection, and signs of heart failure.
Pictures will be taken of the chest. This can be done with:
- Chest x-ray
- Echocardiography
- CT scan of chest
Treatment
The underlying cause will be treated.
The goal of treatment is to help promote breathing. Choices are:
- Mechanical ventilation—a machine will move air in and out of the lungs
- Non-invasive mask mechanical ventilation—a mask will deliver air from a ventilator to the lungs
- Oxygen therapy—a mask or tube will deliver oxygen through the nose
- Extracorporeal membrane oxygenation (ECM)—advanced breathing and heart support (not as common)
Prevention
There are no known guidelines to prevent this problem.
RESOURCES:
American Lung Association
http://www.lung.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov
REFERENCES:
Acute respiratory distress syndrome (ARDS). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-respiratory-distress-syndrome-ards. Accessed October 29, 2020.
Explore ARDS. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhoIsAtRisk.html. Accessed October 29, 2020.
Sweeney RM, McAuley DF. Acute respiratory distress syndrome. Lancet. 2016 Nov 12;388(10058):2416-2430.
Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 4/30/2021