2021-2022

Erbil Polytechnic University

Erbil Technical Institute

Anesthesia department

Report about :

Acute respiratory distress syndrome

Prepared by :
Wali baqi bakr
Fatima kamal ahmad
Ismail yousif tahir
Fatima hemin ali
Sewakhan fakher Abubaker

Supervised by :
Ms.Shireen Mahmood
Table contents
 Introduction
 Symptoms
 What causes ARDS?
 Diagnosis
 Complications
 Treatment
 Reference
Introduction
Acute respiratory distress syndrome (ARDS) is a serious lung condition that
causes low blood oxygen. People who develop ARDS are usually ill due to another
disease or a major injury. In ARDS, fluid builds up inside the tiny air sacs of the
lungs, and surfactant breaks down. Surfactant is a foamy substance that keeps the
lungs fully expanded so that a person can breathe. These changes prevent the lungs
from filling properly with air and moving enough oxygen into the bloodstream and
throughout the body. The lung tissue may scar and become stiff.

ARDS may develop over a few days, or it can get worse very quickly. The first
symptom of ARDS is usually shortness of breath. Other signs and symptoms of
ARDS are low blood oxygen, rapid breathing, and clicking, bubbling, or rattling
sounds in the lungs when breathing.

ARDS can develop at any age. To diagnose ARDS, your doctor or your child’s
doctor will do a physical exam, review the patient’s medical history, measure
blood oxygen levels, and order a chest X-ray. Supplying oxygen is the main
treatment for ARDS. Other treatments help make you more comfortable or aim to
eliminate the cause of ARDS. Treatments for ARDS may help prevent serious or
life-threatening complications, including organ damage or organ failure.

Symptoms
The signs and symptoms of ARDS can vary in intensity, depending on its cause
and severity, as well as the presence of underlying heart or lung disease. They
include:
 Severe shortness of breath
 Labored and unusually rapid breathing
 Low blood pressure
 Confusion and extreme tiredness

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What causes ARDS?
ARDS happens when the lungs become severely inflamed from an infection or
injury. The inflammation causes fluid from nearby blood vessels to leak into the
tiny air sacs in your lungs, making breathing increasingly difficult.
The lungs can become inflamed after:
 pneumonia or severe flu
 sepsis
 a severe chest injury
 accidentally inhaling vomit, smoke or toxic chemicals
 near drowning
 acute pancreatitis – a serious condition where the pancreas becomes
inflamed over a short time
 an adverse reaction to a blood transfusion

Diagnosis

Your doctor will diagnose ARDS based on your medical history, a physical exam,
and test results. ARDS can be difficult to diagnose and is often mistaken for
another condition, so it is important to know your symptoms.

medical history

To help diagnose ARDS, your doctor may ask you about any medical conditions or
recent events that could be considered risk factors. For example, travelling could
be a risk factor because of potential exposure to infections that are more common
in certain geographic areas. Your doctor may also ask about your symptoms and
whether you have a heart problem, such as heart failure, or another condition that
can cause signs and symptoms similar to those for ARDS.

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physical exam

Your doctor will examine you for signs of ARDS. This exam may include:

 Listening to your lungs through a stethoscope for abnormal breathing

sounds, such as crackling

 Listening to your heart for a fast heart rate

 Checking for signs that you are having difficulty breathing, such as using
muscles in your chest to help you breath

 Examining your skin or lips for a bluish tone, which can signal a low blood
oxygen level

 Examining your body for swelling or other signs of extra fluid, which may
be linked to heart or kidney problems

 Measuring your blood pressure and oxygen levels

Diagnostic test and procedures

To diagnose ARDS, your doctor may have you undergo some of the following
tests and procedures. Different tests may be appropriate for different ages.

 Blood tests to measure the oxygen level in your blood using a sample of
blood taken from an artery. A low blood oxygen level might be a sign of
ARDS. In order to confirm the cause of your symptoms, your doctor may
also check your blood for signs of infection or a heart problem, or to see
how well other organs are working.

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  Chest X-ray to create detailed images of the inside of your chest. This test is
generally the standard for showing excess fluid in your lungs.

 CT (computed tomography) scan of the chest or abdomen to create

detailed images of your lungs or check for abdominal infections.

 Other tests of blood oxygen levels, such as pulse oximetry, that do not

require collecting a blood sample. For these tests, a sensor is attached to the
skin or placed on a hand or foot.

Tests for other medical conditions

Other tests can help find the cause of your ARDS or determine if there is another
type of problem. These include:

 A sputum culture to help find the cause of an infection. The culture is used
to study the phlegm you have coughed up from your lungs.

 Bronchoscopy to diagnose a lung problem when there is no clear cause of

your ARDS. As part of this test, your doctor may rinse an area of your lung
to get cells and examine them under a microscope or with other tests.

 Echocardiogram or a lung ultrasound. These tests can help your doctor

rule out heart failure, congenital heart defects, or other breathing problems.

 Lung biopsy, when other tests do not confirm a diagnosis

 Urine test to detect bacterial infections or rule out kidney problems

Reminders

 Return to Risk Factors to review infections, lifestyle, or other factors that

increase your risk of developing ARDS.

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  Return to Signs, Symptoms, and Complications to review common signs
and symptoms of ARDS.

Complications

If you have ARDS, you can develop other medical problems while in the hospital.
Some can be life-threatening. The most common problems are:

 Atelectasis, when small air pockets in the lung collapse

 Complications of treatment in a hospital. Such complications include

blood clots that can form from lying down for long periods, weakness in
muscles used for breathing or moving around, infections, stress ulcers, and
depression or other mood disorders. Problems with thinking, memory, and
judgment also can result from the long-term use of sedative medicines.

 Failure of multiple organs. The body’s organs may not work as well or

may stop working altogether if they do not get enough oxygen. This lack of
oxygen may cause several organs to stop working at the same time, setting
up a potentially life-threatening situation.

 Pulmonary hypertension, or an increase in blood pressure in the major

artery leading from the heart to the lungs. This condition may occur when
the blood vessel narrows as a result of damage from inflammation or
mechanical ventilation. ARDS may also cause tiny clots to form in blood
vessels in the lungs.

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Treatment

if you develop ARDS, you'll probably be admitted to an intensive care

unit (ICU) and use a breathing machine (ventilator) to help your
breathing.

The goal of treatment for ARDS is to improve oxygen levels and treat the
underlying cause. Other treatments aim to prevent complications and make you
comfortable.

Breathing support

Oxygen therapy to raise the oxygen levels in your blood is the main treatment for
ARDS. Oxygen can be given through tubes resting in your nose, a face mask, or a
tube placed in your windpipe.

Depending on the severity of your ARDS, your doctor may suggest a device or
machine to support your breathing. These include:

 Non-invasive ventilation, such as bilevel positive airway pressure (BiPAP)

or continuous positive airway pressure (CPAP) devices. These electronic
breathing devices help keep your airways open by blowing air through a face
mask.

 A ventilator. Your doctor will adjust the ventilator settings to help prevent

any more damage to your lung tissue. If the ventilator helps restore your

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 blood oxygen levels and it is easier to breathe on your own, your doctor may
turn off the ventilator to see if you are ready for it to be removed completely.
Some people transition from a ventilator to portable oxygen therapy. Risks
from being on a ventilator include pneumonia and pneumothorax, which
can cause your lungs to collapse.

Medicines

Your doctor may recommend medicine to relieve symptoms, treat the underlying
cause, or prevent complications from being in a hospital. These may include:

 Acid-reducing medicines to prevent stress ulcers, which can cause bleeding

in the intestines.

 Antibiotics to treat or prevent infections. If you are on a ventilator, your

healthcare team may do tests, such as lung fluid lab tests or CT scans, to
look for signs of new infection.

 Blood thinners to stop blood clots from forming or growing larger. Heparin

is a common blood thinner for adults.

 Muscle relaxants to help prevent coughing or gagging while on a ventilator

or to reduce the amount of oxygen your body needs.

 Pain medicines, which your doctor may prescribe, depending on your

needs.

 Sedatives to help relieve anxiety, make it easier to breathe on a ventilator, or

lower your body’s oxygen needs. Sometimes your doctor may pair a
sedative with another medicine to make it easier to deliver the oxygen.
Complications vary depending on the sedative used, the dose, and how long
it is used. They can include depression, post-traumatic stress disorder

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 (PTSD), problems with thinking or memory, or a delay in removing the
ventilator.

Other treatment

Your doctor may recommend other treatments, including:

 Blood transfusion to treat low hemoglobin levels. Hemoglobin carries

oxygen in the blood, so a transfusion can improve the delivery of oxygen to
the body’s organs.

 Extracorporeal membrane oxygenation (ECMO) or a similar

device, especially for severe ARDS. ECMO helps when ventilation alone
cannot deliver enough oxygen or while a patient waits for a lung transplant.
ECMO works like an artificial lung, removing carbon dioxide and pumping
oxygen-rich blood back into the body.

 Fluid management. Your healthcare team will monitor the fluid balance in

your body. Low blood pressure can occur when the fluid in your blood
vessels is low. This may prevent oxygen from getting to your organs. To
help restore the balance, your doctor may give you fluid through an
intravenous (IV) line. When you have too much fluid in the lungs, your
doctor may give you medicines that help your body get rid of it.

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  Nutritional support. You may need a feeding tube to make sure you get
enough of the right nutrients while you are on a ventilator.

 Physical therapy to maintain muscle strength and prevent sores from

forming. Movement may help shorten the time you are on a ventilator and
improve recovery after you leave the hospital.

 Positioning your body. For severe ARDS, your doctor may recommend that
you spend most of the time lying facedown, which helps oxygen get to more
of your lungs.

References

 Acute respiratory distress syndrome (ARDS) - NHS (www.nhs.uk)

 Acute Respiratory Distress Syndrome | NHLBI, NIH
 ARDS - Symptoms and causes - Mayo Clinic
 ARDS Treatment and Recovery | American Lung Association
 Acute respiratory distress syndrome (nih.gov)