Acute Respiratory Distress Syndrome (ARDS)

Home » Acute Respiratory Distress Syndrome (ARDS) » Causes, Signs and Symptoms, Diagnosis, Complications

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Causes

There are a number of underlying conditions that can lead to ARDS. However, in most cases, people with these conditions do not develop ARDS. It is not clear why some people are at a higher risk than others.

Causes of ARDS include the following:

• Serious infection in the blood or other tissues (called sepsis; accounts for more than 30% of cases)
• Severe chest trauma
• Severe lung infection (e.g., bacterial or viral pneumonia)
• Inhalation of vomited stomach contents
• Inhalation of smoke or other toxic fumes
• Fat embolis (globule of fat that blocks an artery)
• Near drowning
• Massive blood transfusion
• Cardiopulmonary bypass surgery
• Ingestion of certain drugs
• Acute pancreatitis

Signs and Symptoms

The symptoms of ARDS develop suddenly and include the following:

• Dyspnea (audible, labored breathing, shortness of breath)
• Tachypnea (abnormally rapid breathing)
• Severe hypoxaemia (decreased oxygen concentration in the blood)
• Pulmonary hypertension (high blood pressure in the pulmonary arteries)
• Cyanosis (bluish discoloration of the skin due to poor oxygenation of the blood)
• Presence of abnormal deposits in the lungs (detected by chest x-rays)

Diagnosis

ARDS is diagnosed primarily on the basis of the following clinical features:

• Chest x-ray abnormalities (e.g., presence of fluid in the alveolar space of both lungs; changes on x-ray may lag several hours behind functional changes detected in arterial blood gas analysis)
• Abnormalities in the arterial blood gas analysis that reflect difficulties in achieving sufficient oxygen levels in the blood
• Absence of clinical evidence of left atrial hypertension of other causes of diffuse pulmonary infiltrates (e.g., congestive heart failure, pulmonary hemorrhage)
• Abnormally low blood pressure in the pulmonary arteries

Complications

Complications of ARDS include the following:

• Multiorgan failure (or multiple organ dysfunction syndrome): The same inflammatory processes that injure the alveoli and capillary endothelial cells can damage other organs, including the liver, kidney, brain, blood, and immune system.
• Irreversible pulmonary fibrosis (permanent scarring of lung tissue): Pulmonary fibrosis can lead to prolonged mechanical ventilation and lung dysfunction. Fibrosis decreases the abilities of the lungs to expand and oxygen to cross the alveolar-capillary barrier.

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