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.
The ventilator is used until breathing can resume naturally. If the ventilator is needed for more than a few days, it may be necessary to place the breathing tube directly into the windpipe by making a small cut in the neck (tracheostomy).
Fluids: Given through an intravenous (IV) line or feeding tube, fluids provide nutrition, prevent dehydration, and improve blood flow. The right balance is needed to ensure that the lungs don't fill with fluid but that blood and oxygen can reach all the body's organs.
Medicines: The doctor may give one or more types of medications such as:
- Antibiotics for infection
- Anti-inflammatories to reduce inflammation
- Diuretics to reduce fluid buildup
- Inhaled bronchodilators to open the air passages
The hospital staff will take great precautions to help prevent complications from a lung injury and ARDS and to treat organ system failure immediately. In addition to infection and blood clots from lying down for long periods, other complications may include lung scarring and a collapsed lung. Lung scarring from ARDS or the ventilator makes it difficult for the lungs to expand and fill with air. In many cases, scarring heals during the hospital stay. A lung injury or a ventilator can also cause air to collect in the space around the lungs, causing one or both lungs to collapse. Putting a tube into the chest to remove air allows the lungs to expand once again.