Acute Respiratory Distress Syndrome ARDS for nurses and nursing students with Podcast

Acute Respiratory distress syndrome ARDS

Acute Respiratory Distress Syndrome ARDS

What is Acute Respiratory Distress Syndrome (ARDS)? Acute Respiratory Distress Syndrome ARDS happens when the alveoli in the lungs (tiny air sacs) builds up fluid. If there is more fluid in your lungs, this means that there is less oxygen (O2) circulating in your body. Once this happens your vital organs are not getting an adequate amount of O2 to function correctly.

Nursing students will learn that ARDS usually occurs with patients who are already critically ill, have had significant trauma and/or injuries. The main symptom of ARDS is severe shortness of breath, this symptom usually occurs within hours or days after the trauma or illness occurred.

The survival rate with ARDS is low. The survival rate is usually dependent on the degree of the illness or trauma that was suffered. Even when patients recover from ARDS,  there is a chance that they may have residual damage to the lungs.

Sign and Symptoms

Depending on the severity and cause, along with other pre-existing factors, the signs and symptoms of ARDS can vary in severity.

  • Rapid and labored breathing
  • Severe shortness of breath
  • confusion and extreme fatigue
  • hypotension (low blood pressure)


Causes

The basic cause of ARDS is that the tiny air sacs in the lungs (alveoli) have filled with fluid. This stops the blood from being oxygenated. While there is a membrane that usually keeps the fluid in the vessels and not in the alveoli, there is inflammation that was caused by the initial illness or trauma which inhibits this membrane from functioning adequately and allows the fluid to leak into the alveoli.  Here are some of the most common causes of ARDS:

    • Sepsis: This is the most common cause of ARDS. This is because there is a major infection in the bloodstream.

 

  • Major trauma (chest, head, etc): These injuries can damage the part of the brain that is responsible for breathing or the damage can be done by direct injury such as a car accident.

 

 

  • Inhalation of toxic substances: Smoke or chemicals in high concentrations can cause ARDS. Aspirating ( inhaling emesis) can also lead to ARDS.

 

 

  • Pneumonia: If pneumonia is severe enough to effect all 5 lobes of the lungs, ARDS can develop.

 

 

 

Complications

ARDS can have long lasting complications. Some of these complications include:

  • Pneumonthorax – A collapsed lung may occur from the use of a ventilator as the tidal volume and pressure force gas into the lung.
  • Pulmonary fibrosis – Scarring of the lung tissue may occur, which stiffens the lung tissue and impedes oxygen flow from the alveoli to the blood stream.
  • Infections – Ventilators can make it easier for germs to travel into the body.
  • Blood clots – This is due to decreased immobility. This can predispose a patient to DVT’s and Pulmonary Embolisms.
  • Abnormal lung function: it may take up to 2 years for patients with ARDS to fully recover and have normal lung function if at all.  Unfortunately, some may require supplemental oxygen at home.

Tests

Arterial blood gasses are done to check oxygen levels in the blood.

Chest X-ray will be done to see how much of the lung is affected.  This will also let the physician see if the heart is enlarged.

CT scan will give more detailed information about the heart and lungs than the chest x-ray.

Standard blood tests (CBC, CMP) to assess for infection.

EKG: to see how the heart is functioning and if any cardiac arrhythmias are present.

Echocardiogram: to see if the structures in the heart itself are being affected.

Treatments and Medications

  • Oxygen: Either by cannula, mask, or ventilator depending on the patients status.
  • Fluids: but must be monitored carefully as fluid can buildup in the lungs.
  • Medications: Antibiotics to fight infection. Pain medications to relieve discomfort. Sedatives especially on ventilator. Anticoagulants to prevent blood clots.

 

Disclaimer:

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN-BC, BSN, PHN, CMSRN Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process. She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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