Acute respiratory distress syndrome is a respiratory condition in which the air sacs in the lungs get filled with fluid causing difficulty in breathing. According to Thompson, Chambers, & Liu (2017) the condition is associated with acute medical procedure or problem and occurs in the situation; there is trauma to the lungs. Such trauma can be directly or indirectly. Some of the traumas include severe pneumonia, near drowning, breathing in smoke, and sepsis. Response to trauma is characterized by an inflammatory reaction which produces a natural molecule (Villar, Blanco & Kacmarek, 2016). Often, the reaction is a protective mechanism against injury or infection. However, Thompson et al., (2017) argue that not all inflammatory reactions are positive in some people as it may lead to a leak of fluids into the lungs. With the tiny air sacs (alveoli) filled with fluids, less oxygen reaches the body organs. Such a state is often life-threatening as the lungs become stiff, thus cannot inflate. The condition increases the rate of breathing to get air into the lungs leading to respiratory failure. ARDS is a life-threatening condition that often poses a severe threat to a person's life, and without immediate medical attention, a patient may die.
Causes of Acute Respiratory Distress Syndrome
Some of the leading causes of ARDS include:
- Lung injury that may result from high intake of concentrated oxygen
- Chest injury
- Pregnancy complications such as miscarriage, infection of uterus tissues before or after abortion, or miscarriage.
- High inhalation of deadly gases or large quantity of smoke
- Extensive, severe infection (sepsis)
- Drug overdose such as aspirin, propoxyphene, or heroin.
- Transfusion of a large amount of blood (more than 15 units) within a short time (Thompson et. al., 2017).
Signs and Symptoms
ARDS symptoms and signs appear between 1 to 3 days after a trauma or injury. The first sign a person experience is often shallow and rapid breathing. The victim also experiences shortness of breath. These are often characterized by a wheezing sound originating from the lungs. Due to low oxygen flow in the body organs, the person's skin will appear bluish or mottled, leading to cyanosis. Thompson et al., 2017) add that other organs such as the brain and heart may also malfunction, leading to rapid heart rate, sleepiness, confusion, and irregular heart rhythms. The patient will also experience muscle fatigue, headaches, and general body weakness. Other signs and symptoms include hacking, dry coughs, labored breathing, and fever.
Villar et al., (2016) posit that acute respiratory distress syndrome requires early diagnosis as it is considered a medical emergency. Early diagnosis is critical in helping the patient survive. Diagnosis can be carried out in various ways, and there is no automatic test to diagnosing the state. Other tests include taking the victim's blood pressure, undertaking a physical examination, CT scan, blood test, chest X-ray, nose, and throat swabs. For example, an X-ray entails an imaging test that produces images of the chest. A chest image can indicate any disease or abnormality in the heart, lungs, blood vessels, and airwaves (Thompson et al., 2017). The chest X-ray can thus be used to determine the presence of air or fluid in the lungs.
According to Villar et al., (2016), a CT scan provides a detailed analysis and information of the internal images, especially the blood vessels and soft tissues around the chest region of a potential suspect involved in a chest injury. CT scan produces images from all angles of the body. Electrocardiogram or echocardiogram can be applied to rule out any abnormality or injury to the heart. Although a lung biopsy is useful, it is rarely used. However, it is an essential examination for ruling out a lung infection or abnormality. Thompson et al., (2017) state that an airway examination is also critical to help establish any potential problems experienced during breathing. The review is also vital in evaluating the physical condition of an adult's airway, especially one who is involved in an accident. The amount of oxygen in the blood can also be measured by using a blood sample and undertaking an analysis.
Persons with ARDS undergo treatment in the ICU (Intensive Care Unit). The success of the treatment is dependent on other underlying medical conditions such as pneumonia. However, the principal aim of any ARDS treatment is to increase the amount of oxygen to the failed organs (Villar et al., 2016). Oxygen can be administered through the mask or a ventilation machine in which air is pushed into the lungs to reduce/lower the amount of fluid in the alveoli.
Body Fluid Management
Another treatment plan/option is the management of fluids that aims at ensuring that there is sufficient fluid balance in the body. For example, a large amount of fluids may lead to an accumulation of fluids in the lungs (Thompson et al., 2017). At the same time, little fluid may lead to strained heart and organs.
There are various medications that an individual diagnosed with ARDS can be given. These medications can be given to reduce discomfort with antibiotics prescribed mainly to treat any prevalent infection. Medication can also be given to reduce the chances of blood clotting in the lungs.
According to Thompson et al., (2017) individuals recovering from the condition often require pulmonary rehabilitation that aims at increasing the lung capacity and strengthening the respiratory organs. Pulmonary rehabilitation programs include lifestyle classes and exercise training. They may also need support teams to help them recover from the condition.
Villar et al., (2016) argue that the U.S. alone experiences approximately 200000 cases of the condition each year. However, the majority of patients are in the hospital due to some other trauma or disease. The American College of Chest Physician approximate that approximately 30 to fifty percent of patients diagnosed with ARDS die with those surviving ending up spending long periods in hospital. In countries such as Europe, Finland, and the Scandinavia, the prevalence varies. In Europe, the condition varies with Europe at 10.6 per 100,000 persons yearly. According to Villar et al., (2016) Finland ranges at 17.8 yearly, Scandinavia at 25.4 percent annually, and Spain at 24.6 percent per 100,000 persons yearly (Villar et al., 2016). The prevalence thus varies from continent to continent with geographical difference noted mostly in children. The condition is, however, challenging as those under care often develop related health complications such as kidney failure, severe muscle weakness, collapsed the lung, or pneumonia.
Thompson, B. T., Chambers, R. C., & Liu, K. D. (2017). Acute respiratory distress syndrome. New England Journal of Medicine, 377(6), 562-572. http://discovery.ucl.ac.uk/1570129/1/Chambers_nejmra1608077.pdf
Villar, J., Blanco, J., & Kacmarek, R. M. (2016). Current incidence and outcome of acute respiratory distress syndrome. Current opinion in critical care, 22(1), 1-6. https://www.researchgate.net/profile/Jesus_Villar/publication/286413456_Current_incidence_and_outcome_of_the_acute_respiratory_distress_syndrome/links/5b8682e1a6fdcc5f8b6ed5f1/Current-incidence-and-outcome-of-the-acute-respiratory-distress-syndrome.pdf
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