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acute respiratory distress syndrome, ARDS
Adult respiratory distress syndrome (ARDS) is a condition that causes severe inflammation in the lungs. This inflammation reduces lung function and may cause lung, or respiratory, failure.
What is going on in the body?
When a person has ARDS, the lungs and tiny blood vessels around the lungs become inflamed, or swollen. This inflammation interferes with the lung's ability to function properly. The lungs have difficulty getting oxygen into the bloodstream and removing carbon dioxide from the blood. As inflammation increases, fluid can leak from the blood vessels into the lungs. As fluid builds up and inflammation increases, the lungs become stiff and may fail completely, which can cause death. ARDS usually occurs due to another major serious condition in the body, such as trauma or infection.
What are the signs and symptoms of the disease?
Some of the symptoms associated with ARDS depend on the cause. Symptoms may include: What are the causes and risks of the disease?
Causes of ARDS include:
Other causes are also possible. Sometimes the cause is unknown.
- inhaling the contents of the stomach, known as aspiration pneumonia
- severe trauma to the lungs, such as from a crush injury to the chest
- inhaling smoke or toxic fumes, such as fumes from chlorine or ammonia
- serious infections, such as sepsis, a life-threatening infection of the bloodstream
- infection of the lungs, such as pneumonia
- serious inflammation in other parts of the body, such as acute pancreatitis
- serious trauma to other parts of the body
- blood transfusions of large amounts of blood
- drug overdose
- near drowning
What can be done to prevent the disease?
Prevention of ARDS depends on the cause. Avoiding exposure to infection may prevent some cases that are caused by infection. Avoiding smoking, drugs, and alcohol may decrease the risk of lung problems in general. Seeking prompt treatment for illnesses may also decrease the risk of ARDS. Many cases cannot be prevented.
How is the disease diagnosed?
After doing a complete history and physical examination, the doctor may have some tests done to diagnose ARDS. These include:
What are the long-term effects of the disease?
- chest x-ray
- a full blood count, or FBC, to check for infection
- arterial blood ?gas?es, to measure the level of oxygen in the blood
- culture of any fluid that has been drained from the lungs
- various tissue and blood cultures to check for the source of an infection
- pulmonary artery catheterisation, which is a special x-ray test that looks at blood flow and blood pressure in the lungs
- pulmonary function tests, which measure lung capacity and other vital functions
Sometimes a person can recover from ARDS with no long-term effects. Often, however, a person will have ongoing lung problems, including infections. ARDS often leads to death in severe cases. Other long-term effects are related to the cause of ARDS. For example, pneumonia can permanently damage the lungs and even cause death in some cases.
What are the risks to others?
Adult respiratory distress syndrome itself is not contagious. If ARDS is caused by an infection, such as pneumonia, the infection may be contagious.
What are the treatments for the disease?
Treatment of ARDS is done in a hospital, often in the intensive care unit. Treatment may include: 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, or allergic reaction to anaesthesia .
What happens after treatment for the disease?
In many cases, no further measures are needed after treatment of ARDS, and the person is able to return to normal activities. Often, however, a person will have to battle ongoing lung problems. He or she may need physiotherapy and pulmonary therapy to strengthen the body and the lungs. In many cases, ARDS leads to death due to lung failure.
How is the disease monitored?
Arterial blood gases and chest x-rays will be done repeatedly until the person improves. Any new or worsening symptoms should be reported to the doctor.
Author: Eileen McLaughlin, RN, BSN
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 25/04/2005
Potential conflict of interest information for reviewers available on request