Acute Respiratory Distress Syndrome (ARDS) – Symptoms and Causes

Understanding ARDS

Acute respiratory distress syndrome (ARDS) is a serious lung condition. It develops when inflammation causes fluid buildup in the alveoli (tiny air sacs) of the lungs. This fluid accumulation occurs because inflammation damages the protective membrane surrounding these air sacs.

When fluid fills the alveoli, they cannot properly fill with air. This reduces oxygen transfer to the bloodstream. As a result, vital organs don’t receive enough oxygen to function properly.

ARDS typically affects people who are already seriously ill or have suffered major injuries. The main symptom—severe shortness of breath—usually appears within hours to days after the triggering illness or injury.

Key Facts About ARDS:

• Develops rapidly in critically ill patients
• Reduces oxygen delivery to vital organs
• Often leads to respiratory failure

The mortality rate for ARDS is significant, with risk increasing with age and illness severity. Among survivors, recovery outcomes vary considerably:

• Complete recovery (some patients)
• Permanent lung damage (others)
• Lingering respiratory issues

Early recognition and treatment are crucial factors that can influence patient outcomes.

Signs and Problems

When someone has ARDS, their symptoms can range from mild to severe. The seriousness often depends on what caused ARDS and if the person already has heart or lung problems.

Common symptoms include:

• Difficulty breathing that feels severe
• Unusual breathing patterns that seem labored or fast
• Coughing
• Pain or discomfort in the chest area
• Rapid heartbeat
• Mental confusion and extreme fatigue

When Medical Help Is Needed

Most people with ARDS are already in the hospital when it develops. However, if you notice these symptoms in yourself or someone else who isn’t currently under medical care, seek emergency help immediately.

Call 911 or go to the nearest emergency room without delay. ARDS is a serious condition that requires prompt medical attention.

Causes

ARDS can develop from several different conditions. The most common trigger is sepsis, a serious bloodstream infection that spreads throughout the body.

Severe pneumonia that affects multiple areas of the lungs can also lead to ARDS. When pneumonia becomes widespread in the lungs, it can cause the type of damage that leads to respiratory distress.

People with severe COVID-19 infections may develop ARDS as the virus attacks the respiratory system. The resulting inflammation and fluid buildup can severely damage lung tissues.

Major trauma from accidents like car crashes or serious falls can trigger ARDS. This includes injuries to the chest, head, or other parts of the body.

Inhaling harmful substances can cause direct lung damage leading to ARDS:

• Smoke inhalation
• Chemical fumes
• Stomach contents (vomit)
• Water (in near-drowning cases)

Other potential causes include:

• Severe pancreatitis (pancreas inflammation)
• Multiple blood transfusions
• Extensive burns

Risk Factors

Most people who develop ARDS are already hospitalized for other conditions, often in critical care. Several factors can increase a person’s risk:

Medical Conditions:

• Infections (sepsis, pneumonia)
• COVID-19, especially with metabolic syndrome
• Prior lung damage

Substance Use:

• Alcohol use disorder
• Recreational drug use
• Tobacco smoking or history of smoking

These lifestyle habits can harm the lungs and make them more vulnerable to ARDS. People with past substance use also face higher risks, as previous damage to lung tissue can make respiratory distress more likely during illness.

Complications

ARDS can lead to several health problems during hospital stays. These issues require careful monitoring and treatment by healthcare professionals.

Blood clots pose a serious risk for patients with ARDS. When patients remain immobile while on ventilators, clots may form in the deep veins of their legs.

These clots can break loose, travel to the lungs, and block blood flow. This dangerous condition is called pulmonary embolism.

Ventilator use, while lifesaving, can sometimes cause a collapsed lung (pneumothorax). The pressure from the ventilator may force air through a small hole in the outer part of a lung, causing it to collapse. This complication requires immediate medical attention.

Infections are more common in ARDS patients using ventilators. The breathing tube inserted into the windpipe creates an easy path for germs to enter the lungs. These infections can worsen lung damage and slow recovery.

Long-term Lung Damage

Pulmonary fibrosis can develop within weeks of ARDS onset. This condition involves scarring and thickening of lung tissue between air sacs. The scarring makes lungs stiffer and further blocks oxygen from entering the bloodstream.

Stress ulcers may form in the stomach during severe illness. The body produces extra stomach acid when under stress, which can irritate the stomach lining and create painful ulcers.

After-Hospital Effects

Many ARDS survivors face ongoing challenges after leaving the hospital:

Challenge	Description	Duration
Breathing problems	Shortness of breath, fatigue, possible need for oxygen	Months to years
Mental health issues	Depression and anxiety	Often treatable
Cognitive difficulties	Memory loss, trouble thinking clearly	May improve or persist
Physical weakness	Muscle weakness, extreme tiredness	Requires rehabilitation

While improved treatments have increased survival rates, recovery from ARDS often involves dealing with lasting effects. Most people regain substantial lung function within several months to years. However, some patients experience breathing problems for life.

Breathing difficulties are common after ARDS. Many survivors need extra oxygen at home for months after leaving the hospital. Even those who recover well often experience shortness of breath and tiredness during daily activities.

Depression affects most ARDS survivors. The physical trauma, hospitalization, and lifestyle changes can trigger mental health challenges. Healthcare providers can offer treatment options to help patients cope with these feelings.

Cognitive problems may develop during ARDS treatment. Low oxygen levels and sedative medications can harm brain function, leading to memory loss and learning difficulties. Some patients see improvement over time, while others face permanent cognitive changes.

Muscle weakness is another common issue. Extended hospital stays, especially with ventilator use, cause muscles to weaken significantly. This weakness, combined with fatigue, can make simple tasks difficult during recovery.

Prevention of Complications

Healthcare teams work to prevent these complications through several methods:

• Early mobility exercises when possible
• Blood thinners to prevent clots
• Careful ventilator management
• Infection control practices
• Proper positioning to reduce pressure injuries
• Stomach acid reducers to prevent ulcers

Rehabilitation plays a key role in recovery. Physical therapy helps rebuild muscle strength. Occupational therapy teaches new ways to perform daily tasks. Respiratory therapy improves breathing capacity.

Family support is vital during the recovery process. Loved ones can help with daily care, provide emotional support, and assist with medical appointments.

For some patients with severe, permanent lung damage who don’t respond to other treatments, lung transplantation may be considered as a last resort option, though this is uncommon.