Ards Adult Respiratory Distress Syndrome

Adult respiratory distress syndrome, which is also calledARDS, is a breakdown in the function of the lungs that comes on suddenly.With this condition, there is severe inflammation in the lungs.This inflammation reduces the lungs’ ability to take up oxygen. It maycause lung or respiratory failure. Although called “adult,” ARDS can alsooccur in children.

What is going on in the body?

ARDS is usually brought on by some otherserious condition in the body, such as trauma or infection, that directly or indirectlyinjures the lung. When a person has ARDS, the lungs and tiny blood vesselsaround the lungs become inflamed and swollen. This inflammation interfereswith the lungs’ ability to function properly. The lungs have a hard time gettingoxygen into the bloodstream and removing carbon dioxide from the blood.As inflammation increases, fluid can leak from the blood vessels into thelungs. As fluid builds up and inflammation increases, the lungs becomestiff and may completely fail to work. .

What are the causes and risks of the disease?

More than 30 percent of people who havesepsis,which is a life-threatening infection of the bloodstream, will develop ARDS.Some of the other causes of ARDS are:

blood transfusionsof large amounts of blood

burns

drug overdose

infection of the lungs, such as bacterial or viralpneumonia

inhaling large amounts of smoke

inhaling toxic fumes, such as those from chlorine or ammonia

inhaling the contents of the stomach, known asaspiration pneumonia

near drowning

serious inflammation in other parts of the body, such asacute pancreatitis

prolonged or severe shock

surgery, such as cardiopulmonary bypass

severe trauma to other parts of the body

severe trauma to the lungs, such as from acrush injuryto the chest

What are the signs and symptoms of the disease?

Symptoms of ARDS can vary, depending on the cause, butthey usually develop within 1 to 3 days after a trauma or infection damagesthe lungs. Shortness of breathoccurs first, followed in most cases by rapid, shallow breathing. Other symptomsmay include:

anxietyand restlessness

cognitive impairment,which means having a hard time thinking

discoloration of the skin, including cyanosis,which is a bluish color in the skin, even with oxygen therapy

decreased urination

muscle weakness

noisy breathing

rapid heartbeat

How is the disease diagnosed?

After doing a complete medical history and physical exam,the doctor may suspect ARDS. This is especially true when shortness ofbreath develops in a person who has had severe trauma or infection. Teststhe doctor may order include:

arterial blood gases,to measure the level of oxygen in the blood

chest X-rayto visualize the structure and integrity of the lungs

a complete blood count, called CBC,to check for infection

culture of any fluid that has been drained from the lungs, to check for infection

pulmonary artery catheterization, which is a special X-ray test that looksat blood flow and blood pressure in the lungs

pulmonary function tests,which measure lung capacity and other vital functions

various tissue and blood culturesto check for the source of an infection

What can be done to prevent the disease?

Prevention of ARDS depends on the cause. Avoidingexposure to infection may prevent some cases that are caused byinfection. Avoiding smoking,drugs, and alcoholmay decrease the risk of lung problems in general. Seeking prompt treatmentfor illnesses may also decrease the risk of ARDS. Many cases can’t beprevented.

What are the long-term effects of the disease?

Four out of ten people who have ARDS will die from it, evenwith treatment. But the other 60 percent will survive, if they receive the righttreatment. Those who respond quickly to treatment often have no long-termeffects. But those who needed to stay on a ventilator for a long time to treattheir ARDS may have ongoing lung problems, including infections.Other long-term effects are related to the cause of ARDS. For example,pneumoniacan permanently damage the lungs and even cause death.

What are the risks to others?

ARDS itself is not catching. If it is caused by an infectionsuch as pneumonia,the infection may be contagious.

What are the treatments for the disease?

People with ARDS must be treated in a hospital, often in theintensive care unit.Keeping the person’s oxygen intake within healthy limits is key, as well astreating the underlying cause of the lung injury. It is also crucial to maintain theperson’s fluid balance. Either too much ortoo little fluid can be harmful and will affect the outcome of ARDS.Treatment may also include:

antibiotics to treat infections or sepsis

surgery, if an injury caused the ARDS

use of a ventilator,which is an artificial breathing machine

Research is also promising for several other treatments, includingreplacement surfactant and anti-inflammatory agents, but more study is needed.

What are the side effects of the treatments?

Side effects depend on the treatments used. For example,antibiotics can cause stomach upset, allergic reaction,and other effects. Surgery poses a risk of infection, bleeding, orallergic reactionto anesthesia.

What happens after treatment for the disease?

In many cases, no further measures are needed after treatmentof ARDS, and the person is able to return to his or her usual activities. Often,however, a person will have to battle ongoing lung problems. He or shemay need physical therapyand pulmonary therapy to strengthen the body and the lungs.

How is the disease monitored?

Arterial blood gasesand chest X-rayswill be done repeatedly until the person improves. Any new or worseningsymptoms should be reported to the doctor.