LESTER PAUL R.

SIVILA BSN 4B

ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

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 made by your body that keeps your lungs
fully expanded so you can breathe. The fluid buildup and lack of surfactant that happen
because of ARDS prevent the lungs from properly filling with air and moving enough
oxygen into the bloodstream and throughout the body. The lung tissue may scar and
become stiff.

CAUSES

ARDS is caused when fluids leak from small lung vessels into lung air sacs
(alveoli). When the protective membrane between blood vessels and air sacs is
compromised, levels of oxygen in the blood decrease.

Causes of ARDS include:

 Sepsis: The most common cause of ARDS, a serious infection in the lungs
(pneumonia) or other organs with widespread inflammation.
 Aspiration pneumonia: Aspiration of stomach contents into the lungs may cause
severe lung damage and ARDS.
 The coronavirus (COVID-19): The infection COVID-19 may develop into severe
ARDS.
 Pancreatitis (severe inflammation in the pancreas), and massive blood
transfusion.
 Major trauma and burns: Accidents and falls may directly damage the lungs or
other organs in the body that trigger severe inflammation injury in the lungs.
 Inhalational injury: Breathing and exposure to high concentrations of chemical
fumes or smoke.
 Drug overdose: An overdose on drugs like cocaine and opioids.

SYMPTOMS
Difficulty breathing is usually the first symptom of acute respiratory distress
syndrome (ARDS). Other symptoms may vary depending on how serious the
underlying cause is. ARDS may take several days to develop, or it can rapidly get
worse. Complications may include blood clots, infections, additional lung problems, or
organ failure.

Warning signs that you are developing or are at risk for ARDS may include:

 Shortness of breath
 Fast breathing, or taking lots of rapid, shallow breaths
 Fast heart rate
  Coughing that produces phlegm
 Blue fingernails or blue tone to the skin or lips
 Extreme tiredness
 Fever
 Crackling sound in the lungs
 Chest pain, especially when trying to breathe deeply
 Low blood pressure
 Confusion

COMPLICATIONS
Complications and problems from ARDS may develop while a patient is in the hospital
or after discharge.

 Blood clots or deep vein thrombosis.

 Collapsed lung (pneumothorax). This may result from pressure applied by the
ventilator to the injured stiff lungs.
 Confusion (delirium).
 Muscle weakness.
 Scarred lungs or lung fibrosis.
 Post-traumatic stress disorder (PTSD).
 Anxiety and depression.

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

Oxygen therapy

Oxygen therapy is a treatment that delivers oxygen for you to breathe. You can
receive oxygen therapy from tubes resting in your nose, a face mask, or a tube placed in
your trachea (windpipe). You may need oxygen therapy if you have a condition that
causes your blood oxygen levels to be too low.

Oxygen therapy can be given for a short or long period of time in the hospital, in
another medical setting, or at home. Oxygen poses a fire risk, so you should never
smoke or use flammable materials when using oxygen. You may experience side effects
from this treatment, such as a dry or bloody nose, tiredness, and morning headaches.
Oxygen therapy is generally safe.

Other breathing support

Depending on how serious your symptoms are, your doctor may suggest a device
or machine to support your breathing:

 Noninvasive ventilation, such as use of bilevel positive airway pressure

(BiPAP) or continuous positive airway pressure (CPAP) machines, which are
 electronic breathing devices that help keep your airways open by blowing air
through a face mask.
 A ventilator may help restore your blood oxygen levels. Some people transition
from a ventilator to portable oxygen therapy. Risks from being on a ventilator
include pneumonia and pneumothorax (collapsed lung).

Medicines

Your doctor may recommend medicines to relieve symptoms, treat

the underlying cause, or prevent complications from being in a hospital:

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

intestines.
 Antibiotics 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 stop blood clots from forming or growing larger. Heparin is a
common blood thinner for adults.
 Muscle relaxants help prevent coughing or gagging while on a ventilator or
reduce the amount of oxygen your body needs.
 Sedatives 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 delivering the oxygen easier. Complications vary
depending on the sedative used, the dose, and how long it is used. They can
include depression, post-traumatic stress disorder (PTSD), problems with
thinking or memory, or a delay in removing the ventilator.

Other treatments

Your doctor may recommend other treatments, including the following:

 A feeding tube can ensure you get enough of the right nutrients while you are
on a ventilator.
 Blood transfusions 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 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 through an intravenous (IV) line helps restore fluid levels
if needed. Low fluid levels in your blood vessels can prevent oxygen from getting
to your organs. If you have too much fluid in the lungs, your doctor may give you
medicines that help your body get rid of the extra fluid.
 Lying facedown helps get more oxygen to your lungs.
 Physical therapy maintains 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.