• Adult Respiratory Distress Syndrome

    (ARDS; Acute Respiratory Distress Syndrome; Non-cardiogenic Pulmonary Edema)


    Adult respiratory distress syndrome (ARDS) is a form of lung failure. It is a life-threatening lung condition. ARDS can occur in very ill or severely injured people. It is not a specific disease.
    ARDS starts with the tiny blood vessels in the lungs. These vessels leak fluid into the lung sacs. The fluid decreases the ability of the lungs to move oxygen into the body.
    ARDS can develop in anyone over the age of one year old.
    Adult Respiratory Distress Syndrome
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    ARDS can be caused by many types of injuries, including:
    • Direct injury to the lungs:
    • Chest trauma, such as a heavy blow
    • Aspiration of stomach contents
    • Obstructed airways
    • High attitude disease
    • Tuberculosis
    • Oxygen toxicity
    • Radiation
    • Cardiopulmonary bypass
    • Breathing smoke, chemicals, or salt water
    • Burns
    Indirect injury to the lungs:
    • Severe infection
    • Massive blood transfusion
    • Pneumonia
    • Shock
    • Burn
    • Head trauma
    • Severe inflammation of the pancreas—pancreatitis
    • Overdoses of alcohol or certain drugs, such as aspirin, cocaine, opioids, phenothiazines, and tricyclic antidepressants
    ARDS may occur within few days of a lung or bone marrow transplantation.

    Risk Factors

    ARDS develops most often in people who are being treated for the conditions listed above. Very few who have these issues will go on to develop ARDS.
    Other factors that may increase your chance of ARDS include:
    • Cigarette smoking
    • Chronic lung disease
    • Age over 65


    ARDS may cause:
    • Shortness of breath
    • Fast, labored breathing
    • Bluish skin or fingernail color
    • Rapid pulse
    • Fever
    • Chills
    • Muscle pain or weakness
    • Headache
    • Dry Cough
    They often develop within 24-48 hours of the injury. If you or someone else is experiencing any symptoms, seek medical help


    Doctors may suspect ARDS when:
    • A person suffering from severe infection or injury develops acute, severe breathing problems
    • A chest x-ray shows fluid in the air sacs of both lungs
    • Blood tests show a dangerously low level of oxygen in the blood
    • Other conditions that could cause breathing problems have been ruled out
    The doctor will ask about symptoms and medical history. A physical exam will be done. People who develop ARDS may be too sick to complain of symptoms. Tests may include:
    • Blood pressure check
    • Blood tests—to look for oxygen levels, evidence of infection, and markers of heart failure
    • Chest x-ray
    • Swabs from nose and throat for identifying viruses
    • Occasionally, an echocardiogram, to rule out heart failure
    • Pulmonary artery catheterization to aid in diagnostic work-up
    • Bronchoscopy to analyze airways—a laboratory examination may indicate presence of certain viruses or cancer cells
    • Open lung biopsy is reserved for cases when diagnosis is difficult to establish


    If you are able talk with the doctor about the best plan for you. Treatment options include the following:
    • Treating the underlying cause or injury
    • Providing support until the lungs heal:
      • Mechanical ventilation—a machine to help you breathe through a tube placed in the mouth or nose, or through an opening created in the neck
      • Monitoring blood chemistry and fluid levels
      • Oxygen via a face mask or nasal prong
    Often, ARDS patients are sedated to tolerate these treatments.


    To help reduce your chance of getting ARDS, seek timely treatment for any direct or indirect injury to the lungs.


    American Lung Association http://www.lung.org

    National Library of Medicine http://www.nlm.nih.gov


    Health Canada http://www.hc-sc.gc.ca

    The Lung Association http://www.lung.ca


    Acute respiratory distress syndrome (ARDS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 12, 2015. Accessed June 30, 2015.

    Bernard GR. Acute respiratory distress syndrome: A historical perspective. Am J Respir Crit Care Med. 2005;172(7):798-806.

    Bernard G, Artigas A, Carlet J, et al. The American-European consensus conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3 Pt 1):818-824.

    Bosma KJ, Lewis JF. Emerging therapies for treatment of acute lung injury and acute respiratory distress syndrome. Expert Opin Emgerg Drugs. 2007;12(3): 461-477.

    Explore ARDS. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards%5FWhoIsAtRisk.html. Updated January 12, 2012. Accessed January 2015.

    Jain R, DaiNogare A. Pharmacological therapy for acute respiratory distress syndrome. Mayo Clin Proc. 2006;81(2):205-212.

    Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005;353(16):1685-1693.

    Udobi KF, Childs E, Touijer K. Acute respiratory distress syndrome. Am Fam Physician. 2003;67(2):315-22.

    Understanding ARDS. ARDS Support Center website. Available at: http://www.ards.org/learnaboutards/whatisards/brochure. Accessed June 30, 2015.

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