What is Acute Respiratory Distress Syndrome?

Acute Respiratory Distress Syndrome (ARDS) is a life-threatening illness in which the lungs are severely inflamed. Swelling throughout the lungs cause tiny blood vessels to leak fluid and the air sacs (alveoli) collapse or fill with fluid, preventing the lungs from working well. Patients with ARDS have problems getting enough oxygen into their blood so they must be given extra oxygen and will usually need a ventilator to breathe. Despite intensive treatment, about 40% of people with ARDS die from lung failure

Who gets ARDS?

It is estimated that ARDS affects about 150,000 Americans each year. ARDS can occur in many situations. ARDS can affect people who have known lung disease or other serious illnesses. A person can develop ARDS even if he or she has not had lung disease or a lung problem in the past.

What causes ARDS?

The causes of ARDS are not well understood. Either direct or indirect injuries can cause ARDS. Direct injuries include: pneumonia, inhaling stomach contents (aspiration), breathing in harmful fumes or smoke, and injury to the chest that causes bruising of the lungs. Indirect injuries include: severe and widespread bacterial infection in the body (sepsis), severe injury to the body that causes low blood pressure, bleeding that requires blood transfusions, and inflammation of the pancreas (acute pancreatitis).

What are the symptoms of ARDS?

Common symptoms include: shortness of breath, cough (often with white or pink frothy sputum), fatigue, fever, or abdominal pain (in pancreatitis).

How is ARDS diagnosed?

There are a number of tests the healthcare team may do to see if a person has ARDS, including chest X-rays, blood tests, and examination of the blood or sputum (phlegm) to determine if infection is present. It can be difficult to diagnose ARDS in people who have underlying medical problems that have similar symptoms. Pneumonia can share many of the same symptoms as ARDS and may progress to ARDS.

How is ARDS treated?

Currently, there is no specific treatment for ARDS. Treatment consists of two goals:

What is an ICU and what can I expect to see in the unit?

Intensive care units (ICU) are areas in the hospital where the most seriously ill patients are cared for by a specially trained healthcare team. The team includes doctors, nurses, respiratory therapists, dietitians, physical therapists, pharmacists, psychologists, social workers, and chaplains. The ICU team works together closely to provide the best possible care. Patients in the ICU are often connected to a variety of machines, monitors, and tubes needed to help the person recover. This can feel overwhelming to see all this equipment and you can ask the team questions to help you know what is happening.

What complications may occur with ARDS?

There are a number of problems that can occur when a person has ARDS including:

  • Collapse of part or all of one or both lungs (pneumothorax) may occur due to ARDS or use of the mechanical ventilator. To re-expand the lung, a chest tube (thoracostomy tube) may need to be inserted.
  • Infections can develop that will need to be treated with antibiotics.
  • Change in patient’s thinking, typically confusion (called ICU delirium). This may occur due to variety of factors including side effects from medications, lack of sleep, pain, infections, or lack of oxygen being delivered to the body. This usually improves or resolves with time as the person gets better.
  • Damage to major organs (kidney, heart, liver, brain, blood) may occur due to effects of severe infections or lack of oxygen being delivered throughout the body. Sometimes even with intensive care and use of a ventilator, the lungs are too damaged to deliver enough oxygen. Damage to any of these major organs can be very serious and require additional treatment. Having many organs functioning poorly results in a greater risk of death.

Is ARDS fatal?

ARDS is a serious, sometimes fatal medical problem that can also be very unpredictable. Some people recover within a short period of time, while others may not recover for weeks or months. Some people have no complications at all and others seem to develop many complications. Some people with ARDS die quickly, while others die after a prolonged illness. The ups and downs of this critical illness may seem like an “emotional rollercoaster” for patients, families and friends. Yet, many people do survive. It is important for family and friends to remain hopeful, and seek guidance about how they can help promote healing. It is also important that family members take care of themselves to avoid getting too tired or worn down. Talking with the medical team to understand what is happening and what might be expected day to day may be helpful. After leaving the hospital, the ARDS survivors may need help while recovering at home though the amount of help needed will vary. They may need oxygen (temporarily or permanently) or physical or occupational therapy. They may also continue to experience the following problems, either temporarily or permanently: shortness of breath, cough, phlegm or sputum production from the lungs, hoarseness, lack of energy and loss of stamina, muscle weakness, anxiety, depression of post-traumatic stress disorder (PTSD). (See ATS Patient Information Series fact sheet on Post ICU Syndrome.)

A person recovering from ARDS will need check-ups with his or her healthcare provider, who will monitor his/ her improvement, and check his/her lung function on a regular basis. The healthcare provider may also refer the person to a pulmonary specialist or a pulmonary rehabilitation program to help him or her regain strength and stamina.

TAKEAWAY POINTS

✔ ARDS is a serious life threatening problem that requires intensive care.

 ✔ Injury to the lungs may be corrected quickly or require weeks to months of treatment.

 ✔ It is common for family members and friends of a person with ARDS to have many questions.

✔Write down your questions and talk regularly with the healthcare team.

✔ Support your loved one by learning what you can do to promote his or her recovery.

 

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