ACUTE RESPIRATORY DISTRESS SYNDROME

Acute respiratory distress syndrome is a spectrum of symptoms that arise due to severe respiratory dysfunction.

It commonly occurs due to chronic infection in lung, muscle spasm, and secondary pulmonary diseases such as pneumonia,

ARDS is characterized by severe breathing difficulty, respiratory failure, severe hypoxia. ARDS patient is treated in a hospital emergency ward. Common treatments is artificial ventilation and curing the underlying cause of ARDS.

ARDS can complicate other disease conditions such as respiratory failure, pneumonia, pulmonary embolism, multiple organ failure.

Cause

ARDS causes are,

• Infection 

Presence of infection in the lung area causing swelling, breathing difficulty and muscle spasm in lungs. It can further increase in ARDS sign and symptoms.

• Inhalation of harmful substances 

Inhalation of harmful substances from air pollution, dust, and foam can increase the chance of obstruction in the lungs. This obstruction further can increase lung disorder.

• Airway obstruction 

Airway obstruction due to the presence of block, vasoconstriction, swelling, or blockage can alter respiratory function.

• Chest injury 

Chest injury can damage lung tissues and cells which further result in inflammation of lung tissues obstructing the normal function of the lung.

• Embolism

Embolism is referred as the presence of blockage as material, blood clot, fat embolism, or air in blood vessels. It causes obstruction in lung functions.

• Hemorrhage 

Internal blood accumulation in the lung can cause pleural effusion. It further increase the chances of respiratory difficulty.

• Severe pneumonia 

Severe pneumonia causes high swelling, inflammation of lung cells. It creates much muscle spasm, severe vasoconstriction and produce symptom like breathing difficulty and chest pain. It can complicate into ARDS.

• Pulmonary edema 

Pulmonary edema is referred as the formation or accumulation of excess fluid in lungs. It alter lung function lead to ARDS.

Other Risk factors are,

• A blood clot in the lung
• Drug reactions 
• Autoimmune reaction 
• Other lung diseases 
• Kidney disorders 

Symptom 

ARDS symptoms,

• Cough production 

ARDS increase cough production due to an increase in infectious activity and muscle spasm.

• Presence of wheezing sound 

ARDS produces high cough and sputum in the lung which produces a wheezing sound in the chest area.

• Shortness of breath 

During ards, a person suffers from shortness of breath, due to altering respiratory function.

• Dyspnea 

Dyspnea occurs in inpatient due to low oxygen consumption by tissues and cells.

• Tachypnea 

Tachypnea is referred as rapid breathing occurs due to low airflow in the lungs.

• Cyanosis 

Cyanosis is referred to as bluish discoloration of skin occur due to low oxygen level in the body. It causes cell hypoxia to result in bluish discoloration of the skin.

Other signs are,

• Pallor (unhealthy pale appearance)
• Hypoxia (condition of low oxygen level in the body. )
• Respiratory discomfort
• Restlessness 
• Dizziness 
• Confusion 
• Irritation 
• Itching 
• Fatigue 
• Lethargy 

Diagnosis

ARDS is majorly diagnosed by severe respiratory failure, breathing difficulty and chest pain. Other diagnostic tests is,

• CT Scan

CT scan is done to check inflammation, swelling and edema in the lungs. It is use to visualize lung image for cell and tissue damage.

• Pulmonary function test 

Pulmonary function test is a typical test use to check lung function such as breathing, air flow inside and out, oxygen absorption symmetry of expansion etc. It help to diagnose lung function and extent of the damage.

Pathophysiology

ARDS starts with chronic etiology such as infection, trauma, internal hemorrhage, blood clot in the lungs. It leads to damage and injured normal lung tissues. It lead to produce cough, sputum and muscle spasm in lungs resulting in decrease respiratory function, low tissue perfusion and breathlessness. If remain untreated and infection grows further it decrease function of lung lead to produce severe respiratory failure.

Treatment

Acute respiratory distress syndrome is an emergency condition characterized by severe breathlessness to a person needed artificial ventilation. It is managed in hospital. 

• Tracheostomy 

Tracheostomy is define as a medical procedure in which a tube is insert into the lung through the neck (windpipe). It allows air to enter in the lungs when patient is not able to take air through the nose. 

• Artificial ventilator 

An artificial ventilator is given when the patient is not able to breathe and not able to maintain oxygen ration (SPO2) in body. It maintain air flow in lung and oxygen ration. 

• NSAID 

Non-steroidal anti-inflammatory drug is use to decreas inflammation and swelling in lung. 

• Anti-coagulant 

Anti-coagulant is given to decrease the formation of blood clot in lung. 

• Fluid management 

ARDS patient should receive light diet that is easy to digest such as juices.

• Diet restriction 

Patient receive diet as per physician order. Hard diet may adverse condition of patient. 

• Physiotherapy 

Complication

• Internal bleeding or hemorrhage 
• Malnutrition 
• Multiple organ failure 
• Pulmonary fibrosis 
• Gastrointestinal bleed 
• Kidney failure 
• Congestive cardiac failure 
• Decreased cardiac output 
• Malnutrition 

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