ARDS (Acute Respiratory Distress Syndrome)
How Is ARDS Diagnosed?
There is no test to definitively diagnose ARDS. The doctor will perform a physical exam and listen to your heart and lungs using a stethoscope. If you have ARDS, your doctor will hear abnormal breathing sounds, such as wheezing or crackles.
If you have low blood oxygen levels, your skin and lips may be a bluish color. An arterial blood gas test is done to check the oxygen level in your blood. Low blood oxygen levels can be a sign of ARDS.
Other tests that are done to help diagnose ARDS include:
- Chest X-ray to check for fluid in the air spaces in your lungs
- Complete blood count and other blood tests to look for signs of infection
- Sputum culture to see if bacteria or fungi are present in a sample of mucus that you coughed up from your lungs
- Lung CT scan to look for fluid in the lungs, signs of pneumonia, or other lung problems
Heart tests are also done to rule out heart failure as the cause. Heart failure can cause fluid buildup in the lungs.
How Is ARDS Treated?
Most people who develop ARDS are very sick and already in the hospital. A person who has ARDS is admitted to the hospital's intensive care unit (ICU).
There is no specific treatment for ARDS. The goal is to support breathing and allow the patient's lungs to heal. This involves the use of a breathing machine (mechanical ventilator) and supplemental oxygen. Researchers continue to study new ways to provide patients oxygen. A study by the National Heart Lung and Blood Institute found that smaller puffs of air from a mechanical ventilator lowered the death rate and allowed a patient to be off the machine for more days.
It's also very important to treat the underlying cause of the ARDS. For example, if there is a bacterial infection, antibiotics will be prescribed.
The patient will also be given fluids and nutrients through an IV or feeding tube. The fluid balance will be carefully monitored to make sure fluid does not build up in the lungs.
The Outlook for Patients With ARDS
The survival rate for people with ARDS has improved in recent years, although doctors aren't sure why. Some people who get ARDS make a full recovery, but others have lasting lung damage and long-term breathing problems.
The following factors have been associated with a poor prognosis:
- Active cancer
- Advanced age
- Bacteria blood infection (sepsis)
- Being African-American
- Long-term alcohol abuse
- Long-term liver disease
- HIV infection
- Multiple organ failure
- Organ transplant
It can take many months or even years to recover from ARDS. Some people are very tired and weak after being on a breathing machine, and still have some shortness of breath after going home from the hospital. Pulmonary rehabilitation is an important part of recovery. Such therapy teaches patients how to exercise their lungs and become active again. Support groups and counseling can also be helpful.