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Acute respiratory distress syndrome

From WikiLectures

This article is about acute lung injury in adults (ARDS). Disability in premature infants (RDS) is discussed in the article Respiratory distress syndrome (pediatrics) .

Patient with ARDS

ARDS:


ARDS causes:


ARDS and NRDS:


Acute respiratory distress syndrome (ARDS, a cute respiratory distress syndrome , adult respiratory distress syndrome ) is an acute form of lung damage. ARDS is the result of an inappropriate inflammatory response in the lung tissue, which can be triggered by both infectious and non-infectious agents. During this reaction, lung alveoli are damaged, fluid accumulates in the lungs, and the diffusion path of oxygen is lengthened. ARDS most often occurs as a result of aspiration of gastric contents, severe trauma, lung infection, drowning and is a clinical manifestation of shock lung [1].


Pathogenesis[edit | edit source]

During the inflammatory reaction, the alveoli are damaged, or pneumocytes of the first order. There is a failure of regulatory mechanisms that should remove excess fluid from the alveoli. The following features are characteristic of ARDS itself:

  • increased permeability of pulmonary capillaries,
  • fluid accumulation in the parenchyma and alveoli,
  • diffuse damage to the epithelium of the alveoli - i.e. pneumocytes of the first order.

The result of these changes is, on the one hand , an extension of the diffusion path for blood gases, and on the other hand, the presence of fluid in the lungs. It also contains proteins. ARDS is distinguished from pulmonary edema itself by the presence of proteins in the filtered fluid . The lungs are heavy and edematous. In addition, hemorrhagic exudate is also present in the lungs.

Clinical picture[edit | edit source]

Acute respiratory distress syndrome is characterized by:

  1. shortness of breath
  2. tachypnea,
  3. hypoxemia[1].

Cave!!!.png The most serious symptom is hypoxemia , which does not respond to oxygen treatment and its extent decides the fate of the patient.

The mortality rate of ARDS is 30–60%. The patient dies most often of sepsis and multi-organ failure (MODS).

Diagnosis[edit | edit source]

The diagnosis is determined on the basis of an X-ray image of the lungs, hypoxemia, reduced lung compliance and the absence of increased pressure in the left atrium, or of normal wedging pressure, which indicates that postcapillary pulmonary pressure is not elevated.

Cave!!!.pngARDS must be distinguished from respiratory distress syndrome of prematurity caused by surfactant deficiency .





Links[edit | edit source]

Related Articles[edit | edit source]

External links[edit | edit source]

Source[edit | edit source]

  • NEČAS, Emanuel – ŠULC, Karel – VOKURKA, Martin, et al. Patologická fyziologie orgánových systémů. Část I. 1. edition. Praha : Karolinum, 2006. 0 pp. ISBN 978-80-246-0615-6.


References[edit | edit source]

  1. Jump up to: a b ZVONICEK, Václav. Acute respiratory distress syndrome [online]. Zdravotnic noviny, [cit. 2012-01-27]. <https://zdravi.euro.cz/clanek/priloha-lekarske-listy/syndrom-akutni-dechove-tisne-135694>.

This article is about acute lung injury in adults (ARDS). Disability in premature infants (RDS) is discussed in the article Respiratory distress syndrome (pediatrics) .

Patient with ARDS

ARDS:

START_WIDGET"'-01ec1f6af28b9b08END_WIDGET

ARDS causes:

START_WIDGET"'-d7b953dcd937e8baEND_WIDGET

ARDS and NRDS:

START_WIDGET"'-2cccb1f1fb95e1ffEND_WIDGET


Acute respiratory distress syndrome (ARDS, a cute respiratory distress syndrome , adult respiratory distress syndrome ) is an acute form of lung damage. ARDS is the result of an inappropriate inflammatory response in the lung tissue, which can be triggered by both infectious and non-infectious agents. During this reaction, lung alveoli are damaged, fluid accumulates in the lungs, and the diffusion path of oxygen is lengthened. ARDS most often occurs as a result of aspiration of gastric contents, severe trauma, lung infection, drowning and is a clinical manifestation of shock lung [1].


Pathogenesis

During the inflammatory reaction, the alveoli are damaged, or pneumocytes of the first order. There is a failure of regulatory mechanisms that should remove excess fluid from the alveoli. The following features are characteristic of ARDS itself:

  • increased permeability of pulmonary capillaries,

  • fluid accumulation in the parenchyma and alveoli,

  • diffuse damage to the epithelium of the alveoli - i.e. pneumocytes of the first order.

The result of these changes is, on the one hand , an extension of the diffusion path for blood gases, and on the other hand, the presence of fluid in the lungs. It also contains proteins. ARDS is distinguished from pulmonary edema itself by the presence of proteins in the filtered fluid . The lungs are heavy and edematous. In addition, hemorrhagic exudate is also present in the lungs.

Clinical picture

Acute respiratory distress syndrome is characterized by:

  1. shortness of breath

  2. tachypnea,

  3. hypoxemia[1].

The most serious symptom is hypoxemia , which does not respond to oxygen treatment and its extent decides the fate of the patient.

The mortality rate of ARDS is 30–60%. The patient dies most often of sepsis and multi-organ failure (MODS).

Diagnosis

The diagnosis is determined on the basis of an X-ray image of the lungs, hypoxemia, reduced lung compliance and the absence of increased pressure in the left atrium, or of normal wedging pressure, which indicates that postcapillary pulmonary pressure is not elevated.

ARDS must be distinguished from respiratory distress syndrome of prematurity caused by surfactant deficiency .

START_WIDGET"'-6a2b36497db8ff35END_WIDGET
START_WIDGET"'-d113f734614b3917END_WIDGET
START_WIDGET"'-4d0ce349be9d06ddEND_WIDGET

Source

  • NEČAS, Emanuel – ŠULC, Karel – VOKURKA, Martin, et al. Patologická fyziologie orgánových systémů. Část I. 1. edition. Praha : Karolinum, 2006. 0 pp. ISBN 978-80-246-0615-6.

References

  1. 1 2 ZVONICEK, Václav. Acute respiratory distress syndrome [online]. Zdravotnic noviny, [cit. 2012-01-27]. <https://zdravi.euro.cz/clanek/priloha-lekarske-listy/syndrom-akutni-dechove-tisne-135694>.