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Acute Respiratory Distress Syndrome (ARDS)


Causes, Signs and Symptoms, Diagnosis, Complications

Physician developed and monitored.

Original Date of Publication: 05 Dec 2000
Reviewed by: Stanley J. Swierzewski, III, M.D.

Original Source: http://www.pulmonologychannel.com/ards/causes.shtml

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


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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