Acute Respiratory Distress Syndrome (ARDS) occurs when fluid builds up in the small, elastic air sacs (alveoli) in the lungs.
The liquid makes the lungs do not fill with enough air, which means less oxygen reaches the bloodstream.
This condition deprives organs of the oxygen they need to function.
According to various studies, some people infected with COVID-19 can experience ARDS as the disease progresses.
This condition is commonly experienced by people who are critically ill or have had a serious injury. Severe shortness of breath, the primary symptom of ARDS, also usually develops within hours to days of the triggering injury or infection.
Many people who develop ARDS do not survive. The risk of death increases with age and the severity of the disease.
Of those who survive ARDS, some make a full recovery while others experience permanent damage to their lungs.
Causes of Acute Respiratory Distress Syndrome
ARDS can be caused by a variety of factors, including:
Infection:Pneumonia, sepsis (blood infection), and viral infections such as COVID-19.
Injury:Chest trauma, broken ribs, or head injury.
Aspirations:Inhaling vomit or harmful substances into the lungs.
Inhalation:Inhalation of smoke, toxic chemicals, or water (near drowning).
Pancreatitis:Inflammation of the pancreas.
Blood transfusion:Severe transfusion reaction.
Drug overdose:Overdose of certain medications.
ARDS occurs when the protective lining between the lungs' tiny air sacs and tiny blood vessels (capillaries) leaks. This leak allows fluid from the blood vessels to leak into the air sacs and lungs. This prevents the lungs from supplying oxygen to the bloodstream, preventing the body's organs from getting enough oxygen to function.
According to WHO, early identification and treatment of the causes of ARDS is very important to increase the patient's chances of recovery.
Risk Factors for Acute Respiratory Distress Syndrome
Several factors can increase a person's risk of developing ARDS, including:
Elderly
History of lung disease
Smoking
Alcohol addiction
Critical illness
Obesity
ARDS can vary depending on its severity and cause. Symptoms usually develop within hours to days after the initial illness or injury.
Some common symptoms of ARDS include:
Severe shortness of breath.
Rapid and shallow breathing.
Low blood pressure.
Confusion and dizziness.
Extreme fatigue.
In some cases, ARDS symptoms can progress very rapidly and lead to respiratory failure. It's important to seek immediate medical attention if you experience these symptoms.
Diagnosis Acute Respiratory Distress Syndrome
There is no specific test to identify ARDS. Diagnosis is based on a physical examination, chest X-ray, and oxygen levels. It's also important to rule out other diseases and conditions, such as certain heart problems that can produce similar symptoms.
1. Imaging
Imaging tests include, among others:
Chest X-ray.A chest X-ray can reveal which parts of the lungs and how much of the lungs have fluid in them and whether the heart is enlarged.
Computerized Tomography (CT).A CT scan combines X-ray images taken from different angles into a cross-sectional view of internal organs. A CT scan can provide detailed information about the structures inside the heart and lungs.
2. Laboratory tests
A blood test using an artery in the wrist can measure oxygen levels. Other blood tests can check for signs of infection or anemia. If the doctor suspects a lung infection, respiratory secretions can be tested to determine the cause.
Testing through laboratory tests can be:
Culture or examination of sputum samples, to identify the bacteria or microorganisms causing the infection.
A biopsy, or taking a sample of lung tissue. This test is used to rule out the possibility of symptoms caused by lung diseases other than ARDS.
3. Heart Test
Because the signs and symptoms of ARDS are similar to certain heart problems, your doctor may recommend heart tests such as:
Electrocardiogram.This painless test tracks the electrical activity of the heart. It involves attaching several wired sensors to the body.
Echocardiogram.Cardiac sonogram, this test can reveal problems with the structure and function of the heart.
Treatment of Acute Respiratory Distress Syndrome
The first goal in treating ARDS is to increase blood oxygen levels. Without oxygen, organs cannot function properly.
1. Oxygen
To get more oxygen into the bloodstream, your doctor will likely use:
Supplemental oxygen.For milder symptoms or as a temporary measure, oxygen can be given through a mask that fits over the nose and mouth.
Mechanical ventilation.Most people with ARDS will need mechanical assistance to breathe. A mechanical ventilator pushes air into the lungs and forces some of the fluid out of the air sacs.
Fluid.Careful management of intravenous fluids is crucial. Too much fluid can increase fluid buildup in the lungs. Too little fluid can overload the heart and other organs and lead to shock.
2. Medicines
People with ARDS are usually given medications to:
Prevent and treat infections.
Relieves pain and discomfort.
Prevents blood clots in the legs and lungs.
Minimizes gastric reflux.
Keep them calm.
3. Minimize complications
Steps to minimize ARDS complications are usually:
Sedation to manage pain.
Breathing tests to determine when it is safe to remove the tube and ventilator.
Using blood thinners to prevent clots.
Minimizes fluid buildup in the lungs.
Reduces the possibility of stress ulcers in the stomach.
Be physically active and undergo physical therapy to prevent muscle weakness.
Prevention of Acute Respiratory Distress Syndrome
There is no specific prevention for ARDS, but by knowing the symptoms and signs, doctors can provide treatment as soon as possible to prevent complications.
In addition, there are several steps that can help protect the lungs, such as:
If you smoke, seek help to quit, and avoid secondhand smoke whenever possible.
Do vaccinations like An annual flu (influenza) shot, as well as a pneumonia vaccine every five years, can reduce the risk of lung infections.
Stop consuming alcoholic beverages.
Living a clean and healthy lifestyle.
Be careful when driving and always wear a seat belt or helmet.
Complications of Acute Respiratory Distress Syndrome
If someone has ARDS, they may develop other medical problems while in the hospital. The most common problems are:
Blood Clot.Being hospitalized while on a ventilator can increase the risk of blood clots, especially in the deep veins of the legs. If a clot forms in the legs, part of it can break off and travel to one or both lungs (pulmonary embolism), where it blocks blood flow.
Collapsed Lung or Pneumothorax.In most cases of ARDS, a breathing machine called a ventilator is used to increase oxygen in the body and force fluid out of the lungs. However, the pressure and volume of air from the ventilator can force gas through the small holes in the outermost part of the lungs, causing them to collapse.
Infection.Because the ventilator is attached directly to a tube that goes into the throat, this makes it easier for germs to infect and further injure the lungs.
Pulmonary Scarring or Fibrosis.Scarring and thickening of the tissue between the air sacs can occur within weeks of the onset of ARDS. This stiffens the lungs, making it increasingly difficult for oxygen to flow from the air sacs to the bloodstream.
Thanks to improved treatments, more people are surviving ARDS. However, many survivors end up with potentially serious and sometimes long-lasting effects.
Some of the effects include:
Respiratory Problems.Many people with ARDS recover most of their lung function within a few months to two years, but others may have breathing problems for the rest of their lives. Even healthy people commonly experience shortness of breath and fatigue and may require supplemental oxygen at home for several months.
Depression. Most ARDS survivors also report experiencing periods of depression.
Problems with Memory and Cognitive.Sedatives and low blood oxygen levels can cause memory loss and cognitive problems after ARDS. In some cases, the effects may diminish over time, but in others, the damage may be permanent.
Muscle Fatigue and Weakness.Being in the hospital and on a ventilator can cause muscle weakness. A person may also feel very tired after treatment.