• Adult Respiratory Distress Syndrome

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

    Definition

    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 1 year.
    Adult Respiratory Distress Syndrome
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    Causes

    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.
    ARDS is more common in adults over the age of 65 years. Other factors that may increase your chance of ARDS include:
    • Cigarette smoking
    • Chronic lung disease

    Symptoms

    Symptoms often develop within 24-48 hours of the injury. Symptoms begin slowly and worsen with time.
    Symptoms may include:
    • Shortness of breath
    • Fast, labored breathing
    • Bluish skin or fingernail color
    • Rapid pulse
    • Fever
    • Chills
    • Muscle pain or weakness
    • Headache
    • Dry Cough

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. People who develop ARDS may be too sick to report their symptoms.
    Your bodily fluids and tissues may be tested. This can be done with:
    • Blood tests—to look for oxygen levels, evidence of infection, and markers of heart failure
    • Swabs from nose and throat for identifying viruses
    • Open lung biopsy
    Your bodily structures may need to be viewed. This can be done with:
    Pulmonary artery catheterization may also be done to to test heart function.

    Treatment

    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.

    Prevention

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

    RESOURCES

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

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

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

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

    References

    Acute respiratory distress syndrome (ARDS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2016. Accessed May 4, 2016.

    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 May 4, 2016.

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

    Understanding ARDS. ARDS Support Center website. Available at: http://www.ards.org/learnaboutards/whatisards/brochure. Accessed May 4, 2016.

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