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Feb.01.2021
 Acute Respiratory Distress Syndrome, Adult

Acute Respiratory Distress Syndrome, Adult

Acute respiratory distress syndrome (ARDS) is a life-threatening condition. The lungs become swollen and blood vessels 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. This can damage other vital organs, such as the heart, kidneys, liver, or brain. You will need intensive care in a hospital.

What are the causes?

The condition usually develops as a result of a major illness, surgery, injury, or widespread infection (sepsis). Common causes of the condition include:
  • An infection in the blood or lungs.
  • A serious injury to the chest.
  • A serious injury that causes low blood pressure.
  • A major surgery.
  • Breathing in harmful chemicals, smoke, or water.
  • Blood transfusions.
  • Breathing in vomit (aspiration).
  • Inflammation of the pancreas (pancreatitis).

What are the signs or symptoms?

The main symptoms of this condition are sudden shortness of breath and rapid shallow breathing. Other symptoms may include:
  • A fast or irregular heartbeat.
  • Crackles in the lungs.
  • Skin, lips, or fingernails that look blue (cyanosis).
  • Confusion.
  • Tiredness or loss of energy.
  • Chest pain, particularly while taking a breath.
  • Coughing.
  • Restlessness or anxiety.
  • Fever. This is usually present if there is an underlying infection, such as pneumonia.

How is this diagnosed?

This condition is diagnosed based on:
  • Medical history, including your symptoms.
  • Physical exam.
You may also have other tests, including:
  • A test that measures the percentage 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.
You may also have tests to rule out other conditions, including:
  • Taking a sample of your sputum to test for infection.
  • Heart tests, such as an echocardiogram or electrocardiogram. These tests check for blood flow and the proper functioning of the heart.
  • Taking a sample of your urine to test for infection or kidney problems.
  • Bronchoscopy. During this test, a thin, flexible tube with a light is passed into the mouth or nose, down the windpipe, and into the lungs.

How is this treated?

The treatment goal is to support you while your lungs heal and the underlying cause is treated. Treatment may include:
  • Oxygen therapy.
  • Noninvasive ventilation: A device such as a continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP) machine may be used to help you breathe. The device gives you oxygen and pressure through a mask or helmet.
  • Positioning you to lie on your stomach (prone position).
  • A breathing machine (ventilator) may be used to help you breathe. This device gives oxygen and pressure through a tube that is put through your mouth into the windpipe (trachea) to help you breathe.
    • If this treatment is needed longer term, a tracheostomy may be placed. A tracheostomy is a breathing tube put through your neck directly into the trachea.
  • Fluid and medicine is given through an IV.
  • Medicines may be given to:
    • Help you relax (sedatives).
    • Treat blood pressure.
    • Treat infection (antibiotics).
    • Prevent blood clots (anticoagulants).
    • Help get rid of excess fluid (diuretics).
  • In severe cases, extracorporeal life support (ECLS) may be used. This treatment temporarily takes over the function of the heart and lungs, supplying oxygen and removing carbon dioxide. ECLS 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 an antibiotic medicine, take it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
  • If you are taking blood thinners:
    • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs, such as ibuprofen. These medicines increase your risk for dangerous bleeding.
    • Take your medicine exactly as told, at the same time every day.
    • Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.
    • Wear a medical alert bracelet or carry a card that lists what medicines you take.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
  • Do not drink alcohol if your health care provider tells you not to drink.
  • Rest and 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.
    • Ask friends and family to help you if daily activities make you tired.
    • Attend any physical or pulmonary rehabilitation as told by your health care provider. This can help with muscle weakness and shortness of breath.
    • You may feel depressed, anxious or have trouble with memory and concentration. Talk with your health care provider about ways to help you feel better.

General instructions

  • Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
  • Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

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.

Get help right away if:

  • You have trouble breathing.
  • You develop a rapid heart rate.
  • You develop sudden chest pain that does not go away.
  • You develop swelling or pain in one of your legs.
  • You cough up blood.
  • Your skin, lips, or fingernails turn blue.
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Acute respiratory distress syndrome is a life-threatening condition in which fluid collects in the lungs. This can cause the lungs and other vital organs to fail.
  • The condition usually develops following a major illness, surgery, injury or widespread infection (sepsis).
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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