Diagnosing a Lung Injury
In some cases, the cause of the lung injury is apparent. In other cases, the doctor asks questions and does a physical exam, listening to lungs and heart and checking skin and lip color. To confirm the cause of the symptoms and lung injury, as well as its severity, the doctor may order tests, such as these:
- An arterial blood gas test shows levels of oxygen and carbon dioxide in the blood.
- A chest X-ray takes a picture of the lungs and can reveal extra fluid.
- Blood tests can spot problems such as infection.
- Sputum cultures help pinpoint the cause of an infection.
- A computed tomography (CT) scan creates detailed pictures of the lungs to reveal underlying problems such as an obstruction.
Bronchoscopy can help evaluate lung infections with the help of a viewing tube or, combined with biopsy, may rule out other problems such as tumors.
Heart tests such as an echocardiogram may help rule out other potential causes of fluid buildup in the lungs, such as heart failure.
Treating a Lung Injury
Some lung injuries heal on their own. However, a pneumothorax, for example, may require removal of excess air through a syringe, needle, or suction tube. In some cases, a chest tube is inserted. Rest, elevation of the head of the bed, and other steps may help with healing.
In addition to treating the underlying injury, if needed, a person who develops ARDS is closely cared for in the intensive care unit (ICU), where treatments include:
Oxygen and ventilation: At first, the doctor may provide oxygen through soft, plastic prongs placed into the nose or a mask may be put over the mouth and nose. If this does not raise oxygen levels high enough, a flexible breathing tube may be needed to supply oxygen. The doctor inserts it through the mouth or nose and into the windpipe. A ventilator connected to the breathing tube helps fill the lungs with air while the lungs recover. Medical staff pays close attention to providing the right amount of oxygen in the air and the right amount of air to prevent further lung injury. For example, small, rather than large, amounts of air have been found to work better. A supportive breathing technique called positive end expiratory pressure (PEEP) may also be helpful.