ARDS or acute respiratory distress syndrome is a severe respiratory disorder caused by a buildup of fluid in the air sacs (alveoli) of the lungs. ARDS is an emergency condition that can cause death if not treated immediately.
ARDS is often caused by a critical illness, such as sepsis or severe pneumonia. One of the causes of pneumonia which is currently becoming a pandemic is the Corona virus (COVID-19). According to a number of studies, some COVID-19 patients may develop ARDS in the course of their illness.
If you need a COVID-19 check, click on the link below so you can be directed to the nearest health facility:
- Antibody Rapid Test
- Antigen Swab (Rapid Test Antigen)
ARDS can develop over several days or worsen rapidly. The main symptom is severe shortness of breath.
Causes of Acute Respiratory Distress Syndrome
ARDS is caused by the seepage of fluid from the capillaries in the lungs into the alveoli. Alveoli are collections of air sacs in the lungs that serve as a place for the exchange of oxygen and carbon dioxide.
Normally, the membrane that protects the capillaries keeps fluid in the blood vessels. However, in people with ARDS, injury or serious illness causes damage to the protective membrane so that fluid leaks into the alveoli.
This buildup of fluid makes the lungs unable to fill with air so that the supply of oxygen to the bloodstream and body is reduced. This lack of oxygen supply can cause the cessation of organ function, including the brain and kidneys. If left unchecked, this condition will threaten the life of the sufferer.
Some of the conditions and diseases that can cause ARDS are:
- Injuries to the head or chest, for example from a collision or accident
- Exposure to hazardous substances, such as concentrated fumes or chemical fumes
- Choking on foreign objects
- Transfusion related lung injury (TRALI )
Risk factors for a cute respiratory distress syndrome
ARDS is usually a complication of certain conditions or diseases. Even so, there are several factors that can increase a person's risk of developing ARDS, namely:
- Over 65 years old
- Have an addiction to alcoholic beverages
- Suffering from chronic lung disease
- Suffering from genetic disorders
- Experiencing obesity
- Experiencing an overdose of certain drugs
Symptoms of Acute Respiratory Distress Syndrome
ARDS symptoms that arise in each sufferer can vary, depending on the cause, severity, to the patient's medical history, such as heart disease or lung disease.
Some of the symptoms and signs that can appear in people with ARDS are:
- Short and fast breath
- Hard to breathe
- Low blood pressure ( hypotension )
- Body feels very tired
- Excessive cold sweat
- Blue lips or nails ( cyanosis )
- Chest pain
- Increased heart rate ( tachycardia )
- Headache or dizziness
- Loss of consciousness
When to go to the doctor
Immediately seek medical attention to a doctor if you experience shortness of breath, especially if you are suffering from the diseases mentioned above. You are also advised to seek medical attention immediately if you see a friend or family member experiencing ARDS symptoms.
Diagnosis of Acute Respiratory Distress Syndrome
The doctor will ask about the patient's symptoms and medical history, then perform a physical examination. On physical examination, the doctor will check vital signs, such as respiratory rate or frequency, blood pressure, pulse, body temperature, and bluish color of the lips and nails, along with a physical examination of the chest wall .
To confirm the diagnosis, the doctor will perform a number of other tests, such as:
- Blood tests , to measure oxygen levels in the blood ( blood gas analysis ) and check for anemia or infection
- Chest X-ray , to see the location and amount of fluid buildup in the lungs, as well as detect the possibility of an enlarged heart
- CT scan , to see the condition of the lungs and heart with a more detailed picture
- Echocardiography (heart ultrasound), to assess the condition and structure of the heart and detect heart function disorders
- Electrocardiogram (ECG), to determine the electrical activity of the heart and rule out possible symptoms caused by heart disease
- Culture or examination of a sputum sample, to detect bacteria or other microorganisms that cause infection
- Biopsy or sampling of tissue from the lungs, to rule out symptoms caused by lung diseases other than ARDS
Acute Respiratory Distress Syndrome Treatment
ARDS treatment aims to increase oxygen levels in the blood so that the patient's organs function again and avoid organ failure. Another goal of ARDS treatment is to relieve symptoms and prevent complications.
ARDS patients will usually be treated in the intensive care unit ( ICU ). Some of the treatment methods that will be given in the hospital are:
- Supplemental oxygen administration through a nasal tube or mask for patients with mild symptoms
- Installation of breathing apparatus and ventilators to help circulate oxygen to the lungs
- Giving fluids through an IV to control the amount of fluid in the body
- Provision of nutritional intake using a nasogastric tube inserted through the nose
- Administration of antibiotics to prevent and treat infections
- Giving blood thinning drugs to prevent blood clots in the legs and lungs ( pulmonary embolism )
- Giving pain relievers, drugs to reduce stomach acid, and sedatives
For ARDS patients who are recovering, it is recommended to undergo pulmonary rehabilitation. This action aims to strengthen the respiratory system and increase lung capacity.
Complications of Acute Respiratory Distress Syndrome
People with ARDS can experience complications, both as a result of ARDS itself and as a side effect of treatment. Some of these complications are:
- DVT ( deep vein thrombosis ) or blood clots in the deep veins in the legs due to lying down constantly
- Kidney failure due to impaired oxygen flow to the kidneys
- Pneumothorax or accumulation of air in the pleural membrane, which generally occurs due to air pressure from the use of a ventilator
- Lung infection due to the entry of germs into the lungs through breathing apparatus
- Pulmonary fibrosis or the formation of scar tissue in the lungs that makes it more difficult for the lungs to supply oxygen to the blood
- Brain damage, due to lack of oxygen flow to the brain
In addition to the above complications, ARDS sufferers who manage to recover can experience long-term health problems, such as:
- Respiratory disorders, such as shortness of breath, so that the patient requires oxygen assistance in the long term
- Impaired thinking and memory due to brain damage
- Weakness and muscle atrophy due to prolonged inactivity (in patients who have to lie down for a long time)
Prevention of Acute Respiratory Distress Syndrome
There are several things that can be done to reduce the risk of ARDS, namely:
- Stop smoking and stay away from cigarette smoke
- Do not consume alcoholic beverages
- Undergo flu immunization every year and PCV immunization every 5 years to reduce the risk of lung infections
- Implementing clean and healthy living behavior ( PHBS )
- Be careful when driving and always wear a seat belt or helmet