Acute respiratory distress syndrome

Disease class: Lung diseases

Disease class: Respiration disorders

Also known as

ARDS
Formerly known as Adult Respiratory Distress Syndrome.

 

Definition

A form of acute respiratory failure in which a variety of different disorders give rise to lung injury. The condition has a high mortality rate; it is a complex clinical problem in which an overstimulated immune system plays a major role. 

 Source: Black's Medical Dictionary (42nd ed, 2010, ISBN 978-1-4081-0419-4)

Causes

Direct insult

• Viral, bacterial and fungal pneumonia
• Lung trauma or contusion
• Inhalation of toxic gases or smoke
• Aspiration of gastric contents
• Near-drowning

Indirect insult

• Septic shock
• Haemorrhagic shock
• Cardiogenic shock
• Metabolic disorders
• Uraemia
• Pancreatitis
• Bowel infarction
• Drug ingestion
• Massive blood transfusion
• Transfusion reaction
• Cardipulmonary bypass
• Disseminated intravascular coagulation

Prognosis

• 58% mortality across all centres
• This can be reduced to 25-40% with certain ventilator strategies

Management

• Mechanical ventilation
• Fluid management, prevention of pulmonary oedema