How to cure Acute respiratory distress syndrome ?
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by the rapid onset of widespread inflammation in the lungs
What is Acute respiratory distress syndrome?
Acute respiratory distress syndrome (ARDS) is a condition of the lung that leads to small oxygen levels in the blood.
Acute respiratory distress syndrome is the most important disorder resulting in increased permeability pulmonary edema.
Inciting events include trauma, sepsis, drug overdose, massive transfusion of blood products, acute pancreatitis, or aspiration.
In many cases, the initial event is obvious, but, in others (such as drug overdose) the underlying cause may not be so easy to identify.
It is characterized by inflammation of the lung parenchyma leading to impaired gas exchange with concomitant systemic release of inflammatory mediators causing inflammation, hypoxemia and frequently resulting in multiple organ failure.
This condition is life-threatening and often lethal, usually requiring mechanical ventilation and admission to an intensive care unit.
Acute respiratory distress syndrome usually occurs in people who are very ill with another disease or who have major injuries.
Most people are already in the hospital when they develop ARDS. In acute respiratory distress syndrome, infections, injuries, or other conditions cause the lung’s capillaries to leak more fluid than normal into the alveoli.
This prevents the lungs from filling with air and moving enough oxygen into the bloodstream.
A less severe form is called acute lung injury. Acute respiratory distress syndrome can occur within 24 to 48 hours of an injury or attack of acute illness.
In such a case the patient usually presents with shortness of breath, tachypnea, and symptoms related to the underlying cause, i.e. shock.
Long term illnesses can also trigger it, eg malaria. About one-third of the people with the syndrome develop it as a consequence of a severe, widespread infection (sepsis). Other people develop ARDS because of significant damage at first to another organ, such as the pancreas.
The ARDS may then occur sometime after the onset of a particularly acute case of the infection. Acute respiratory distress syndrome occurs in children as well as adults.
The estimated annual frequency of ARDS is reported as 75 cases per 100,000 population. Most people who develop acute respiratory distress syndrome are in the hospital for another serious health problem.
Why Acute respiratory distress syndrome is increasing?
COVID-19, in the form of the 2019–20 corona virus pandemic, has led to an increase in the incidence of ARDS. Prior to the outbreak of COVID-19 the annual incidence of ARDS was 13–23 people per 100,000 in the general population.
Its incidence in the mechanically ventilated population in intensive care units is much higher.
According to Brun-Buisson et al (2004), there is a prevalence of acute lung injury (ALI) of 16.1% in ventilated patients admitted for more than 4 hours.
Worldwide, severe sepsis is the most common trigger causing ARDS.Other triggers include mechanical ventilation, sepsis, pneumonia, Gilchrist’s disease, drowning, circulatory shock, aspiration, trauma—especially pulmonary contusion—major surgery, massive blood transfusions, smoke inhalation, drug reaction or overdose, fat emboli, and reperfusion pulmonary edema after lung transplantation or pulmonary embolectomy.
However, the majority of patients with all these conditions mentioned do not develop ARDS. It is unclear why some people with the mentioned factors above do not develop ARDS and others do
Rarely, people who aren’t hospitalized have health problems (such as severe pneumonia) that lead to ARDS.- by Wikipedia
Medical treatment of Acute respiratory distress syndrome
The main goals of treating ARDS are to get oxygen to your lungs and organs and treat the underlying condition that’s causing ARDS.
A low tidal volume and low plateau pressure ventilator strategy is recommended to avoid ventilator-induced injury. Timely correction of the inciting clinical condition is essential for preventing further injury.
Acute respiratory distress syndrome is usually treated with mechanical ventilation in the intensive care unit. Empirical therapy may be appropriate if local microbiological surveillance is efficient.
Treatment consists of mechanical ventilation along with careful attention to fluid balance and a supportive breathing technique called positive end-expiratory pressure.
Corticosteroids may sometimes be administered in late phases of ARDS or if the patient is in shock.