Acute respiratory distress syndrome is a life-threatening lung condition that prevents enough oxygen from getting into the blood. It is defined as a sudden and progressive form of acute respiratory failure in which the alveolar-capillary membrane becomes damaged and more permeable to intravascular fluid resulting in severe shortness of breath, a low level of oxygen in the blood and diffuse pulmonary infiltrates.
CAUSES
- Direct lung injury:
Common causes: Aspiration of stomach contents or other substances and viral/bacterial pneumonia.
Less common causes: Chest trauma, inhalation of toxic substances, near-drowning, O2 toxicity, radiation pneumonitis, fat, air or amniotic embolism.
- Indirect lung injury:
Common causes: Sepsis, Severe traumatic injury
Less common causes: Acute pancreatitis, Anaphylaxis, Prolonged cardiopulmonary bypass surgery, Multiple blood transfusions, severe head injury, shock, Massive blood transfusion and Narcotic drug overdose like heroin.
STAGES/TYPES
- Exudative
- Proliferative
- Fibrotic
PATHOPHYSIOLOGY
SIGNS AND SYMPTOMS
- Restlessness
- Shortness of breath
- Low blood pressure
- Confusion
- Extreme tiredness
- Coughs
- Fever
- Cyanosis (blue skin, lips and nails)
- Abnormal breath sounds
- Mental confusion
MANAGEMENT
The patients are usually hospitalized, and they require monitoring in an intensive care unit. The supportive measures include:
- Supplemental oxygen
- Mechanical respirator
- Positional strategies like turning the patient from supine to prone
- Fluid therapy
COMPLICATIONS
- Nosocomial pneumonia
- Renal failure
- Barotrauma
- O2 toxicity
- Stress ulceration
- Pulmonary embolism
REFERENCES
- https://www.healthline.com/health/acute-respiratory-distress-syndrome
- RTC ARDS Jason D. Sciarretta 2010
- ARDS ppt Sanjay 2012