Acute Respiratory Distress Syndrome, Adult

Acute respiratory distress syndrome (ARDS) is when the lungs become inflamed, causing blood vessels to swell and leak fluid into the air sacs (alveoli). This prevents the lungs from working well. It also makes it hard to get oxygen into the blood. As a result, other vital organs can get damaged, such as the heart, kidneys, liver, or brain.

ARDS is a life-threatening condition. It usually needs treatment in an intensive care unit (ICU) in a hospital.

What are the causes?

The condition usually happens because of a major illness, surgery, injury, or widespread infection (sepsis).

• An infection in the blood, lungs, or kidneys.
• A serious injury to the head, chest, or other areas of the body.
• Breathing in harmful chemicals, smoke, water, or vomit.
• Getting donated blood (blood transfusion).
• Inflammation of the pancreas (pancreatitis).

What are the signs or symptoms?

The main symptoms of this condition are sudden shortness of breath and fast, shallow breathing.

• A fast or irregular heartbeat.
• Crackling sounds in the lungs.
• Tiredness or loss of energy.
• Chest pain, especially while taking a breath.
• Coughing.
• Feeling restless or anxious.

How is this diagnosed?

This condition is diagnosed based on your medical history, symptoms, and a physical exam.

• A test that measures the amount of oxygen in your blood (pulse oximetry). This is done with a sensor that is placed on your finger, toe, or earlobe.
• Blood tests.
• Chest X-rays or CT scans to look for fluid in the lungs.
• Tests to rule out other conditions or infections in your body.

How is this treated?

• Oxygen therapy.
• Noninvasive ventilation. This is a device to help you breathe by giving you oxygen and pressure through a mask or helmet. Examples of these machines are:
  • Continuous positive airway pressure (CPAP) machine.
  • Bilevel positive airway pressure (BIPAP) machine.
• Prone positioning. This means having you lie on your stomach.
• A breathing machine called a ventilator. This gives oxygen and pressure through a tube that is put through your mouth and into your windpipe (trachea).
• Tracheostomy placement, if you are on a ventilator for a long time. A tracheostomy is a breathing tube put through your neck into your trachea.
• Fluid and medicine given through an IV.
• Medicines that:
  • Help you relax (sedatives).
  • Treat blood pressure.
  • Treat infection (antibiotics).
  • Prevent blood clots (anticoagulants).
  • Help get rid of extra fluid (diuretics).
• Extracorporeal life support (ECLS), in severe cases. This treatment takes over the actions of the heart and lungs for a short time. ECLS gives oxygen and removes carbon dioxide. It also gives the lungs a chance to rest and recover.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed antibiotics, take them as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

General instructions

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Do not drink alcohol if your health care provider tells you not to drink.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • It may take a while for you to get back to your normal activities and routine.
  • Attend any physical or pulmonary rehabilitation as told. This can help with muscle weakness and shortness of breath.
• You may feel depressed or anxious, or have trouble with memory and focus. Talk with your health care provider about ways to help you feel better.

Where to find more information

• American Lung Association: www.lung.org
• National Heart, Lung, and Blood Institute: www.nhlbi.nih.gov

Contact a health care provider if:

• You become short of breath during activity or while resting.
• You develop a cough that does not go away.
• You have a fever.
• Your symptoms do not get better or they get worse.
• You become anxious or depressed, or you do not feel like doing your normal activities.

Get help right away if:

• You have trouble breathing.
• Your heart starts beating very fast.
• You get sudden chest pain that does not go away.
• You get swelling or pain in one of your legs.
• You cough up blood.
• Your skin, lips, or fingernails turn blue.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Acute respiratory distress syndrome (ARDS) is when the lungs become inflamed, causing blood vessels to swell and leak fluid into the air sacs (alveoli). This prevents the lungs from working well and is life-threatening.
• ARDS usually happens because of a major illness, surgery, injury, or widespread infection (sepsis).
• You may feel depressed or anxious, or you may have trouble with memory and focus. Talk with your health care provider about ways to help you feel better.