Acute Respiratory Distress Syndrome (ARDS) – Overview
Acute Respiratory Distress Syndrome (ARDS) is a life-threatening form of lung failure in which inflammation and fluid buildup severely impair the lungs ability to deliver oxygen to the body.
Wissenswertes über "Acute Respiratory Distress Syndrome"
Acute Respiratory Distress Syndrome (ARDS) is a life-threatening form of lung failure in which inflammation and fluid buildup severely impair the lungs ability to deliver oxygen to the body.
What is Acute Respiratory Distress Syndrome (ARDS)?
Acute Respiratory Distress Syndrome (ARDS) is a severe, life-threatening lung condition in which fluid accumulates in the tiny air sacs of the lungs (alveoli), preventing them from filling with enough air. As a result, the lungs cannot supply sufficient oxygen to the bloodstream. ARDS typically develops as a complication of another serious illness or injury and requires intensive care treatment. It can affect people of all ages and carries a high risk of mortality.
Causes
ARDS can be triggered by a wide range of direct and indirect causes:
Direct Causes (Lung Injury)
- Pneumonia caused by bacteria, viruses, or fungi
- Inhalation of harmful substances (e.g., smoke, gastric acid)
- Near-drowning
- Lung contusion from blunt chest trauma
Indirect Causes (Systemic Conditions)
- Sepsis (a life-threatening response to infection)
- Severe polytrauma (multiple traumatic injuries)
- Massive blood transfusions
- Acute pancreatitis (inflammation of the pancreas)
- Severe burns
Symptoms
Symptoms of ARDS usually develop rapidly, within hours to a few days after the triggering event:
- Severe and rapidly worsening shortness of breath (dyspnea)
- Rapid breathing rate (tachypnea)
- Low blood oxygen levels (hypoxemia), which may cause bluish discoloration of the lips or fingernails (cyanosis)
- Cough, sometimes with frothy sputum
- Confusion and altered consciousness due to oxygen deprivation
- Crackling sounds when breathing
Diagnosis
ARDS is diagnosed according to the Berlin Definition (2012), which includes the following criteria:
- Acute onset within one week of a known clinical insult or new or worsening respiratory symptoms
- Bilateral opacities visible on chest X-ray or CT scan
- Respiratory failure not fully explained by heart failure or fluid overload
- Impaired oxygenation index (PaO2/FiO2 ratio) below defined thresholds
Based on the degree of oxygen impairment, ARDS is classified as mild, moderate, or severe. Diagnostic workup also includes arterial blood gas analysis, laboratory tests, and imaging studies.
Treatment
ARDS is treated exclusively in an intensive care unit (ICU). The primary goals are to ensure adequate oxygenation and to address the underlying cause:
Mechanical Ventilation
The cornerstone of ARDS treatment is mechanical ventilation, typically delivered via an endotracheal tube. A lung-protective ventilation strategy using low tidal volumes and positive end-expiratory pressure (PEEP) is used to prevent further lung injury while keeping the alveoli open.
Prone Positioning
Placing the patient face-down (prone positioning) for extended periods has been shown to significantly improve oxygenation in patients with moderate to severe ARDS by redistributing fluid and improving ventilation-perfusion matching.
Pharmacological Therapy
- Treatment of the underlying cause (e.g., antibiotics for sepsis)
- Corticosteroids in selected cases to reduce inflammation
- Careful fluid management to minimize further pulmonary edema
ECMO
In the most severe cases of ARDS, extracorporeal membrane oxygenation (ECMO) may be used. This technique temporarily takes over the function of the lungs by oxygenating the blood outside the body through a specialized machine.
Prognosis
ARDS carries a significant mortality rate, ranging from approximately 30 to 50 percent depending on severity and underlying cause. Survivors may experience long-term physical impairments, reduced lung function, and cognitive difficulties. Early diagnosis and prompt, evidence-based intensive care management are essential for improving patient outcomes.
References
- ARDS Definition Task Force, Ranieri VM et al. - Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA. 2012;307(23):2526-2533.
- World Health Organization (WHO) - Clinical Management of Severe Acute Respiratory Infection. Geneva: WHO Press, 2019.
- Matthay MA, Zemans RL et al. - Acute respiratory distress syndrome. Nature Reviews Disease Primers. 2019;5:18.
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Related search terms: Acute Respiratory Distress Syndrome + ARDS + Acute Lung Failure + Adult Respiratory Distress Syndrome