Acute Respiratory Distress Syndrome (ARDS) Causes, Symptoms, Diagnosis, Treatment, Home Remedies

Acute Respiratory Distress Syndrome (ARDS) Causes, Symptoms, Diagnosis, Treatment, Home Remedies


What Is Acute Respiratory Distress Syndrome (ARDS)?


Acute respiratory distress syndrome occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. More fluid in your lungs means less oxygen can reach your bloodstream. This deprives your organs of the oxygen they need to function.

Doctors first recognized the syndrome in 1967, when they came across 12 people who developed sudden breathing problems and rapid lung failure. All of them had similar patchy spots on their chest X-rays.

At first, the condition was called adult respiratory distress syndrome, so people would not confuse it with a similar type of lung distress seen in infants. But because acute respiratory distress syndrome can also occur in children aged 1 and older, doctors now refer to it as acute respiratory distress syndrome. Acute means sudden or new.

Acute respiratory distress syndrome may also be called acute lung injury, noncardiac pulmonary edema, and increased-permeability pulmonary edema. In the past it was also called stiff lung, wet lung, and shock lung.

Many people who develop acute respiratory distress syndrome don't survive. The risk of death increases with age and severity of illness. Of the people who do survive acute respiratory distress syndrome, some recover completely while others experience lasting damage to their lungs.

According to the National Heart Lung and Blood Institute, about 190,000 people in the U.S. develop Acute Respiratory Distress Syndrome each year.

What Causes Acute Respiratory Distress Syndrome (ARDS)?


Acute Respiratory Distress Syndrome can occur when a major injury or extreme inflammation somewhere in the body damages the small blood vessels including those in the lungs. As a result, the lungs are unable to fill with air and can't move enough oxygen into the bloodstream.

The lung damage can be direct or indirect.

Conditions that can directly injure the lungs and possibly lead to Acute Respiratory Distress Syndrome (ARDS) include:


  • Breathing in smoke or poisonous chemicals
  • Breathing in stomach contents while throwing up (aspiration)
  • Near drowning
  • Pneumonia
  • Severe acute respiratory syndrome (SARS), a lung infection

Conditions that can indirectly injure the lungs and possibly lead to Acute Respiratory Distress Syndrome (ARDS) include:


  • Bacterial blood infection (sepsis)
  • Drug overdose
  • Having many blood transfusions
  • Heart-lung bypass
  • Infection or irritation of the pancreas (pancreatitis)
  • Severe bleeding from a traumatic injury (such as a car accident)
  • Severe hit to the chest or head
The conditions that have most commonly been linked to acute respiratory distress syndrome include sepsis, traumatic injury, and lung infections such as pneumonia. However, it's important to note that not everyone who has these conditions develops acute respiratory distress syndrome. Doctors are not sure why some people develop acute respiratory distress syndrome and others do not.

What Are the Signs and Symptoms of Acute Respiratory Distress Syndrome (ARDS)?


The first signs and symptoms of acute respiratory distress syndrome are feeling like you can't get enough air into your lungs, rapid breathing, and a low blood oxygen level.

Other signs and symptoms depend on the cause of acute respiratory distress syndrome. They may occur before acute respiratory distress syndrome develops. For example, if pneumonia is causing acute respiratory distress syndrome, you may have a cough and fever before you feel short of breath.

Sometimes people who have acute respiratory distress syndrome develop signs and symptoms such as low blood pressure, confusion, and extreme tiredness. This may mean that the body's organs, such as the kidneys and heart, aren't getting enough oxygen-rich blood.

People who develop acute respiratory distress syndrome often are in the hospital for other serious health problems. Rarely, people who aren't hospitalized have health problems that lead to acute respiratory distress syndrome, such as severe pneumonia.

Complications From Acute Respiratory Distress Syndrome (ARDS)


If you have Acute Respiratory Distress Syndrome, you can develop other medical problems while in the hospital. The most common problems are:  

  • Infections. Being in the hospital and lying down for a long time can put you at risk for infections, such as pneumonia. Being on a ventilator also puts you at higher risk for infections.
  • A pneumothorax (collapsed lung). This is a condition in which air or gas collects in the space around the lungs. This can cause one or both lungs to collapse. The air pressure from a ventilator can cause this condition.
  • Lung scarring. acute respiratory distress syndrome causes the lungs to become stiff (scarred). It also makes it hard for the lungs to expand and fill with air. Being on a ventilator also can cause lung scarring.
  • Blood clots. Lying down for long periods can cause blood clots to form in your body. A blood clot that forms in a vein deep in your body is called a deep vein thrombosis. This type of blood clot can break off, travel through the bloodstream to the lungs, and block blood flow. This condition is called pulmonary embolism.


How is Acute Respiratory Distress Syndrome (ARDS) Diagnosed?


Your doctor will diagnose Acute Respiratory Distress Syndrome based on your medical history, a physical exam, and test results.

Medical History


Your doctor will ask whether you have or have recently had conditions that could lead to acute respiratory distress syndrome.

Your doctor also will ask whether you have heart problems, such as heart failure. Heart failure can cause fluid to build up in your lungs.

Physical Exam


Acute Respiratory Distress Syndrome may cause abnormal breathing sounds, such as crackling. Your doctor will listen to your lungs with a stethoscope to hear these sounds.

He or she also will listen to your heart and look for signs of extra fluid in other parts of your body. Extra fluid may mean you have heart or kidney problems.

Your doctor will look for a bluish color on your skin and lips. A bluish color means your blood has a low level of oxygen. This is a possible sign of Acute Respiratory Distress Syndrome.

Diagnostic Tests


You may have acute respiratory distress syndrome or another condition that causes similar symptoms. To find out, your doctor may recommend one or more of the following tests.

Initial Tests



An arterial blood gas test. This blood test shows the oxygen level in your blood. A low level of oxygen in the blood may be a sign of acute respiratory distress syndrome.

Chest X-ray. This test is used to take pictures of the structures in your chest, such as your heart, lungs, and blood vessels. It can show whether you have extra fluid in your lungs.

Blood tests, such as a complete blood count, blood chemistries, and blood cultures. These tests help find the cause of acute respiratory distress syndrome, such as an infection.

A sputum culture. This test is used to study the spit you've coughed up from your lungs. A sputum culture can help find the cause of an infection.

Other Tests



Chest computed tomography (to-MOG-rah-fee) scan, or chest CT scan. This test uses a computer to create detailed pictures of your lungs. A chest CT scan may show lung problems, such as fluid in the lungs, signs of pneumonia, or a tumor.

Heart tests that look for signs of heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. This condition can cause fluid to build up in your lungs.

How Is Acute Respiratory Distress Syndrome (ARDS) Treated?


he first goal in treating acute respiratory distress syndrome is to improve the levels of oxygen in your blood. Without oxygen, your organs can't function properly.

Oxygen 


To get more oxygen into your bloodstream, your doctor will likely use:

  • Supplemental oxygen. For milder symptoms or as a temporary measure, oxygen may be delivered through a mask that fits tightly over your nose and mouth.
  • Mechanical ventilation. Most people with acute respiratory distress syndrome will need the help of a machine to breathe. A mechanical ventilator pushes air into your lungs and forces some of the fluid out of the air sacs.

Nutritional support


People who have acute respiratory distress syndrome often suffer from malnutrition. Thus, extra nutrition may be given through a feeding tube.

Fluids


Carefully managing the amount of intravenous fluids is crucial. Too much fluid can increase fluid buildup in the lungs. Too little fluid can put a strain on your heart and other organs, and lead to shock.

Medication


People with acute respiratory distress syndrome usually are given medication to:

  • Prevent and treat infections
  • Relieve pain and discomfort
  • Prevent clots in the legs and lungs
  • Minimize gastric reflux

Lifestyle and home remedies for Acute Respiratory Distress Syndrome (ARDS)


If you're recovering from acute respiratory distress syndrome, the following suggestions can help protect your lungs:

  • Quit smoking. If you smoke, seek help to quit, and avoid secondhand smoke whenever possible.
  • Quit alcohol. Alcohol can relax the portion of your upper airway that keeps foreign material from entering your lungs.
  • Get vaccinated. The yearly flu (influenza) shot, as well as the pneumonia vaccine every five years, can reduce your risk of lung infections.

Living with Acute Respiratory Distress Syndrome (ARDS)


Some people fully recover from acute respiratory distress syndrome. Others continue to have health problems. After you go home from the hospital, you may have one or more of the following problems:

  • Shortness of breath. After treatment, many people who have acute respiratory distress syndrome recover close-to-normal lung function within 6 months. For others, it may take longer. Some people have breathing problems for the rest of their lives.
  • Tiredness and muscle weakness. Being in the hospital and on a ventilator (a machine that supports breathing) can cause your muscles to weaken. You also may feel very tired following treatment.
  • Depression. Many people who've had acute respiratory distress syndrome feel depressed for a while after treatment.
  • Problems with memory and thinking clearly. Certain medicines and a low blood oxygen level can cause these problems.
These health problems may go away within a few weeks, or they may last longer. Talk with your doctor about how to deal with these issues. Also, see the suggestions below.

Getting Help


You can take steps to recover from acute respiratory distress syndrome and improve your quality of life. For example, ask your family and friends for help with everyday activities.

If you smoke, quit. Smoking can worsen lung problems. Talk to your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke and other lung irritants, such as harmful fumes.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

Go to pulmonary rehabilitation (rehab) if your doctor recommends it. Rehab might include exercise training, education, and counseling. Rehab can teach you how to return to normal activities and stay active.

Your rehab team might include doctors, nurses, and other specialists. They will work with you to create a program that meets your needs.

Emotional Issues and Support


Living with acute respiratory distress syndrome may cause fear, anxiety, depression, and stress. Talk about how you feel with your health care team. Talking with a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.

Joining a patient support group may help you adjust to living with acute respiratory distress syndrome. You can see how other people who have the same symptoms have coped with them. Talk to your doctor about local support groups or check with an area medical center.

Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.

The Outlook for Patients With Acute Respiratory Distress Syndrome (ARDS)


The survival rate for people with acute respiratory distress syndrome has improved in recent years, although doctors aren't sure why. Some people who get acute respiratory distress syndrome make a full recovery, but others have lasting lung damage and long-term breathing problems.

The following factors have been associated with a poor prognosis:

  • Active cancer
  • Advanced age
  • Bacteria blood infection (sepsis)
  • Being African-American
  • Long-term alcohol abuse
  • Long-term liver disease
  • HIV infection
  • Multiple organ failure
  • Organ transplant
It can take many months or even years to recover from acute respiratory distress syndrome. Some people are very tired and weak after being on a breathing machine, and still have some shortness of breath after going home from the hospital. Pulmonary rehabilitation is an important part of recovery. Such therapy teaches patients how to exercise their lungs and become active again. Support groups and counseling can also be helpful.