Acute respiratory distress
| Acute respiratory distress syndrome | |
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| Synonyms | Respiratory distress syndrome (RDS), adult respiratory distress syndrome, shock lung |
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| Chest x-ray of person with severe ARDS demonstrating widespread "ground-glass" appearing opacities in both lungs | |
| Specialty | Critical care medicine |
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| External resources |
Acute respiratory distress syndrome (ARDS) is a medical condition occurring in critically ill or critically wounded patients characterized by widespread inflammation in the lungs. ARDS is not a particular disease; rather, it is a clinical phenotype which may be triggered by various pathologies such as trauma, pneumonia and sepsis.
The hallmark of ARDS is diffuse injury to cells which form the barrier of the microscopic air sacs of the lungs, surfactant dysfunction, activation of the innate immune system response, and dysfunction of the body's regulation of clotting and bleeding. In effect, ARDS impairs the lungs' ability to exchange oxygen and carbon dioxide with the blood across a thin layer of the lungs' microscopic air sacs known as alveoli.
The syndrome is associated with a death rate between 20 and 50%. The risk of death varies based on severity, the person's age, and the presence of other underlying medical conditions.
Although the terminology of "adult respiratory distress syndrome" has at times been used to differentiate ARDS from "infant respiratory distress syndrome" in newborns, the international consensus is that "acute respiratory distress syndrome" is the best term because ARDS can affect people of all ages.
The signs and symptoms of ARDS often begin within two hours of an inciting event, but can occur after 1–3 days. Signs and symptoms may include shortness of breath, fast breathing, and a low oxygen level in the blood due to abnormal ventilation.
Diffuse compromise of the pulmonary system resulting in ARDS generally occurs in the setting of critical illness. ARDS may be seen in the setting of severe pulmonary (pneumonia) or systemic infection (sepsis), following trauma, multiple blood transfusions (TRALI), severe burns, severe inflammation of the pancreas (pancreatitis), near-drowning or other aspiration events, drug reactions, or inhalation injuries. Some cases of ARDS are linked to large volumes of fluid used during post-trauma resuscitation.
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