The term "acute respiratory distress syndrome" or ARDS for short, describes a particular kind of lung injury that can be brought on by many conditions, such as disease, trauma, or even complications that arise after specific surgical operations. 

With acute respiratory distress syndrome, the lungs suffer a major damage that reduces their capacity to supply enough oxygen to the body organs, and that is why this is a potentially deadly respiratory illness. The illness results in an accumulation of fluid in the lungs, which lowers blood oxygen levels to dangerously low levels and causes a medical emergency. 

ARDS patients need critical care to survive the condition, and delay in care can result in death. Supplemental oxygen therapy is required for all ARDS patients, and the majority will require a mechanical ventilator to aid breathing. Even though ARDS cannot be cured, not everyone who has it will die, and statistics show that an estimated 60% to 75% of people with ARDS will recover from the illness with critical care and long-term treatment.  

What is Acute Respiratory Distress Syndrome (ARDS)?

When fluid accumulates in the tiny air sacs (alveoli) in your lungs, it can cause acute respiratory distress syndrome (ARDS), and as a result of ARDS, your blood oxygen level drops alarmingly (hypoxia), and your lungs are unable to work. Usually, respiratory distress syndrome is classified as mild, moderate, or severe by medical professionals, and they classify the levels by comparing the amount of oxygen in your blood with the required amount for a healthy blood oxygen level. Other organs, including your stomach, heart, kidneys, and brain are unable to receive the oxygen they require to operate because of ARDS, and that’s why ARDS carries a high risk of causing severe and perhaps fatal complications.

When the alveoli and nearby capillaries sustain damage, the lungs' capacity to deliver oxygen to the blood is diminished, and this occurs as a result of fluid seeping into the gaps between the capillaries and the alveoli due to the lung damage. Furthermore, an immunological response is triggered by ARDS, and the damage results in the release of cytokines, which are inflammatory proteins. 

These cytokines attract neutrophils, which are white blood cells, to the lung, and problems occur when certain proteins and cells seep into adjacent blood arteries and spread throughout the body via the circulatory system, inflaming other organs. Low blood oxygen levels combined with this inflammation can cause health issues, including organ failure, and in rare cases, multiple organ failure at the same time.  

ARDS Diagnosis 

There isn't a particular test to diagnose ARDS, and the results of various physical examinations, chest X-rays, and oxygen levels are examined to make the diagnosis. It's crucial to rule out other illnesses and ailments that may cause comparable symptoms, such as specific cardiac issues, and X-rays and CT scans are often used to diagnose ARDS. 

An X-ray of your chest may show you whether your heart is enlarged and which areas of your lungs are filled with fluid, and a CT scan creates cross-sectional pictures of internal organs and provides deep insight.

Doctors measure oxygen levels and perform blood tests to check for other system problems. Doctors may test secretions from the airway if they think the patient has a lung infection in order to identify the infection's source, and due to the similarities between the symptoms and indications of ARDS and certain heart conditions, doctors could advise heart tests such as an echocardiogram and electrocardiogram. 

The heart's electrical activity is monitored using an electrocardiogram, a harmless procedure that entails attaching several sensors to various parts of your body. An echocardiogram, often known as a cardiac ultrasound, can identify issues with the anatomy and operation of your heart and give the doctors the information they need. 

Critical Care Treatment for ARDS 

ARDS currently has no known cure, and the goal of treatment is to keep the patient comfortable and prevent respiratory failure while the lungs mend. The purpose of supportive treatment is to cure the issue that led to the development of ARDS, and to ensure that the body receives adequate oxygen to avoid further damage. 

When critical care treatment for ARDS is received promptly, survival rates can go as high as 70%. Survival chances get reduced if other organs fail or if therapy gets postponed. The prognosis is dependent on several factors, including the underlying medical disorders, medical history, and severity of respiratory distress. 

1.Ventilator Support

Extra oxygen through ventilator support is needed for every ARDS patient because trying to breathe forcefully might harm the lungs. A ventilator is a piece of equipment that helps in breathing by opening up blocked airways, and the patient wears a face mask or has a tube put into their windpipe to connect them to the ventilator.

2. Sedative Use to Stop Movement 

Sedation is frequently required for the ARDS patient to ease dyspnea and avoid agitation, and occasionally, additional drugs known as paralytics are required up front to aid the patient in acclimating to the ventilator. These drugs have serious adverse effects, so it's important to regularly assess the advantages and disadvantages of using them, and do what’s best for the patient’s health.

3. Fluid management

Physicians may prescribe diuretics to patients with acute respiratory distress syndrome (ARDS) in an effort to stimulate urine and flush out extra fluid, and with that, perhaps prevent fluid accumulation in the lungs. Care must be taken since removing too much fluid might cause renal issues and drop blood pressure, so constant supervision is necessary.

4. Prone positioning

ARDS patients are occasionally flipped over onto their stomachs to increase the amount of oxygen in their blood when oxygen and ventilator therapy are at high levels, but blood oxygen is still low. Proning is what it's called, and it can temporarily raise blood oxygen levels, but some people can be too ill to get this treatment since it's a difficult process.

5. Extracorporeal membrane oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO) is a highly technical medical procedure in which blood is extracted from the body and pumped across a membrane to replenish it with oxygen, eliminate carbon dioxide, and then returned to the body. This treatment carries a considerable risk of possible consequences and is not appropriate for every patient with ARDS.

 

Patients with ARDS might need to be ventilated for extended periods, usually taking seven to fourteen days, and after this period, medical professionals could advise having a tracheostomy, or direct insertion of a tube through the neck, performed by a surgeon. Once the patient is no longer in need of a ventilator, this tube can be readily withdrawn, and the majority of ARDS patients recover most of their lung function. Some experience muscular weakness and may need to go back to the hospital or undergo pulmonary rehabilitation to get stronger.

Final Remarks

Acute respiratory distress syndrome (ARDS) may be a terrifying illness, and it has no known cure. ARDS is often excruciating, but younger patients, trauma patients, and cases of ARDS brought on by blood transfusions often see better recovery results. Among the typical warning indicators of a potentially fatal situation are severe hypotension, liver failure, and renal failure, and in these cases, constant critical care must be provided. With proper treatment and effective critical care, up to seventy percent of ARDS patients can survive the condition.  

If you are feeling respiratory distress of any type, you need to go for an immediate checkup. Contact Medanta and book an appointment, today!