Acute respiratory distress syndrome (ARDS)

Abstract

Acute respiratory distress syndrome - known by the acronym ARDS - is a severe, life-threatening consequence of certain pulmonary and systemic insults. The condition typically develops within 24 to 48 hours of the precipitating injury or illness and is characterized by the rapid accumulation of edematous fluid in the lungs as a result of increased capillary permeability. Patients often progress from difficulty breathing due to the fluid in their lungs to inability to breathe without the help of mechanical ventilation. ARDS occurs in a wide range of adult and pediatric critical care settings, often as a sequela of lung trauma but sometimes in the aftermath of serious infection, burn injury, blood loss and other conditions involving shock. Persons particularly susceptible to ARDS include individuals with compromised immune systems, diabetics, the elderly, young children and infants. Early recognition of ARDS and an understanding of its pathophysiology are crucial to its treatment. Clinicians must have a high index of suspicion and anticipate its development in high-risk patients. Inappropriate treatment of the underlying trauma or illness may precipitate ARDS. Assisted ventilation can often improve a patient's chances for survival, but can also contribute to the condition by causing shearing trauma to lung tissues. Even with meticulous care, the prognosis for ARDS is poor: nearly 60 percent of cases are fatal.