Acute respiratory distress syndrome (ARDS) is a rapidly developing, life-threatening condition in which fluid builds up in the air sacs (alveoli) of the lungs preventing oxygen from reaching your bloodstream. This deprives your organs from getting the oxygen they need to function properly.

Causes of ARDS

There are many causes of ARDS. The most common conditions that can injure the lungs and lead to ARDS include:[1]

Sepsis – this serious, widespread infection of the blood is the most common cause of ARDS.

– this serious, widespread infection of the blood is the most common cause of ARDS. Severe pneumonia – lung infections like pneumonia are most commonly linked to ARDS.

– lung infections like pneumonia are most commonly linked to ARDS. Inhalation of smoke or poisonous chemicals – breathing in high concentrations of smoke or other toxic chemicals can damage the lungs and lead to ARDS.

– breathing in high concentrations of smoke or other toxic chemicals can damage the lungs and lead to ARDS. Aspiration – inhaling stomach contents after throwing up is also a common cause of ARDS.

inhaling stomach contents after throwing up is also a common cause of ARDS. Major injuries, especially to the head or chest – serious injuries caused by accidents such as car crashes or falls can cause direct injury to the lungs or the portion of the brain that controls breathing leading to ARDS.

Symptoms of ARDS

The symptoms of ARDS usually come on suddenly within hours or days of the inciting event that caused the initial lung injury. They include:[2]

Severe shortness of breath

Rapid, labored breathing

Rapid heart rate

Extreme sweating

Diagnosing ARDS

There is no test available to specifically diagnose ARDS. Your doctor may establish a diagnosis through physical examination, chest X-ray and blood tests known as arterial blood gases and ruling out other diseases or conditions (such as heart problems) that can produce similar symptoms. Your doctor may also order other blood tests, such as a complete blood count, to check for signs of infection. A cat scan of the lungs can help identify fluid in the lungs, signs of pneumonia or other lung abnormalities. Because the signs and symptoms of ARDS often mimic those of certain heart problems, you doctor may also order heart tests to check for heart abnormalities.

Treatment for ARDS

Many people with ARDS are critically ill and already in the hospital. People who develop the illness and aren’t already hospitalized are admitted and treated in the intensive care unit.[3]

There is no specific medication for ARDS. Treatment that supports breathing and allows the lungs to heal is the main objective in managing the condition and may include:1

Oxygen

One of the most important treatment goals in ARDS is to improve the oxygen levels in the blood. Without the right amount of oxygen, the cells, tissues and organs of the body won’t be able to function properly. To get more oxygen into the bloodstream, your doctor may order:

Oxygen therapy – provided in milder cases and as a temporary measure, supplemental oxygen can be delivered through a mask that fits snugly over your nose and mouth or through nasal prongs inserted into your nose and attached to oxygen tubing.

– provided in milder cases and as a temporary measure, supplemental oxygen can be delivered through a mask that fits snugly over your nose and mouth or through nasal prongs inserted into your nose and attached to oxygen tubing. Intubation and mechanical ventilation – most people with ARDS will need the help of a tube down their throat and a machine to breathe, especially in the initial phases of the illness. A mechanical ventilator pushes air into your lungs and forces some of the fluid out of the air sacs.

Fluid Management

The right amounts of intravenous fluids are critical in the management of ARDS. Too much fluid can increase the fluid buildup in the lungs that is characteristic of ARDS. Too little fluid can put a strain on your vital organs and cause shock.

Medication

People with ARDS are usually given medication to treat the underlying cause of the illness. This can include:

Antibiotics to prevent and treat infections

Pain medication to relieve pain and discomfort

Blood thinners to prevent blood clots in the lungs and legs

Proton pump inhibitors to minimize gastric reflux

Sedation, especially in the case of mechanical ventilation

Prognosis

Because of better care and improved mechanical ventilation treatments, more people are surviving ARDS now than in the past. Although some patients remain on a ventilator for an extended period of time, most can be weaned off as their blood oxygen levels improve and their lungs heal. Some patients recover completely, while others develop long-term lungs problems for years.2

[1] Mayo Clinic. “ARDS”. December 6, 2014.

[2] Cleveland Clinic. “Acute Respiratory Distress Syndrome (ARDS)”. Last reviewed December 3, 2013.

[3] WebMD. “ARDS (Acute Respiratory Distress Syndrome). Last reviewed May 21, 2014.

By Deborah Leader RN, BSN, PHN