ARDS

Acute Respiratory Distress Syndrome (ARDS)

Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition characterized by rapid onset of widespread inflammation in the lungs. It is a critical condition that can occur in patients who are critically ill or have significant injuries.

Pathophysiology

ARDS is caused by damage to the capillary endothelium and alveolar epithelium, leading to increased permeability and fluid accumulation in the alveoli. This results in impaired gas exchange and reduced oxygenation of the blood. The inflammatory response involves the release of cytokines and recruitment of neutrophils, which further exacerbate lung injury.

Causes

ARDS can be triggered by a variety of direct and indirect insults to the lungs, including:

• Pneumonia
• Sepsis
• Aspiration of gastric contents
• Trauma
• Pancreatitis
• Inhalation of toxic substances

Symptoms

The symptoms of ARDS typically include:

• Severe dyspnea (shortness of breath)
• Tachypnea (rapid breathing)
• Hypoxemia (low blood oxygen levels)
• Cyanosis (bluish discoloration of the skin)
• Confusion or lethargy

Diagnosis

The diagnosis of ARDS is based on clinical criteria, including:

• Acute onset of symptoms
• Bilateral opacities on chest imaging
• Absence of left atrial hypertension
• PaO2/FiO2 ratio ≤ 300 mmHg

Treatment

Management of ARDS involves supportive care and addressing the underlying cause. Key components of treatment include:

• Mechanical ventilation with low tidal volumes
• Positive end-expiratory pressure (PEEP)
• Prone positioning
• Conservative fluid management
• Treatment of the underlying condition

Prognosis

The prognosis of ARDS varies depending on the severity of the condition and the underlying cause. Mortality rates range from 30% to 50%. Survivors may experience long-term complications such as reduced lung function and decreased quality of life.

Prevention

Preventive measures for ARDS focus on reducing the risk of lung injury in at-risk patients. This includes:

• Early recognition and treatment of sepsis
• Protective lung strategies during mechanical ventilation
• Minimizing exposure to risk factors

See Also

• Respiratory failure
• Pulmonary edema
• Critical care medicine

External Links

• [American Thoracic Society](https://www.thoracic.org/)
• [National Heart, Lung, and Blood Institute](https://www.nhlbi.nih.gov/)