Acute Respiratory Distress Syndrome (ARDS): A simple explanation

Have you ever heard of someone in the intensive care unit (ICU) having difficulty breathing and being hooked up to a ventilator? Maybe it's happened to one of your own. The main reason for this is often the serious health condition we're going to talk about called ARDS. The name may sound a little scary, but don't worry. We'll explain it in a simple way that you can understand.

What exactly is ARDS?

Simply put, ARDS is severe damage to your lungs. Think of your lungs as two pieces of sponge. Normally, when we breathe, these sponges fill with air. But in ARDS, the tiny air sacs inside these lungs (called alveoli) start to fill with fluid.

Now imagine, when a sponge absorbs water, there is no room for more air to enter it. The same thing happens to the lungs. When water fills up instead of air, the lungs cannot fill with air properly. As a result, the blood does not get the required amount of oxygen. In medicine, we call this condition `(hypoxia)` . This is very dangerous.

Doctors usually classify ARDS into three levels - mild, moderate, and severe. This is determined by comparing the level of oxygen in your blood with the amount of oxygen you need to give outside to bring that level back up to the right level.

ARDS usually occurs when someone is hospitalized for another infection, illness, or serious accident. However, if you develop these symptoms even if you are not hospitalized, it is important to seek medical attention immediately.

What are the main symptoms of this condition?

The symptoms of ARDS can vary depending on the cause, the severity of the condition, and any pre-existing heart or lung conditions you have. However, there are some common symptoms.

ARDS usually develops within hours or days of the triggering event, and the condition can become severe very quickly.

What are the causes of ARDS?

ARDS is not a disease that occurs on its own. It occurs as a result of another medical condition or accident. Let's look at some of the main causes below.

Who is at increased risk?

People who are already hospitalized due to an illness or accident are at the highest risk of developing ARDS. However, not everyone who is hospitalized develops it. There are several other factors that increase the risk:

• Being over 65 years of age.
• Tobacco use (smoking).
• Drug or alcohol addiction.
• Having a pre-existing lung disease.

Other complications that can occur due to ARDS

ARDS doesn't just affect the lungs. It can cause various complications both while in the hospital and after you go home.

• Blood clots: Blood clots can form inside the veins, especially in the legs. We call this ``deep vein thrombosis - DVT``.
• Lung collapse: A damaged lung can burst (pneumothorax) due to the pressure exerted by the ventilator.
• Delirium: Delirium.
• Multiple organ failure: Simultaneous failure of organs such as the brain, heart, and kidneys.
• Muscle weakness: Muscles become weak due to being in bed for days.
• Scarring of the lungs: Scar tissue can form as the lungs heal (lung fibrosis).
• Psychological problems: After facing such a terrible experience, conditions such as post-traumatic stress disorder (PTSD), anxiety, and depression can occur.

How do doctors recognize this?

Because the symptoms of ARDS are similar to other heart or lung diseases, doctors do several tests to confirm whether it is ARDS.

• Chest X-ray: To see how much fluid is in the lungs.
• Blood tests: Measure the oxygen level in the blood and determine the severity of ARDS.
• Echocardiogram: An ultrasound scan to look at the functioning of the heart.
• ECG (Electrocardiogram): View the electrical activity of the heart.
• Pulse Oximetry: Continuous monitoring of oxygen levels using a small device attached to the finger.
• CT scan: Get more detailed information about the lungs.
• Examination of respiratory secretions: Find the cause of the infection.

How is it treated?

The main goal of ARDS treatment is to increase the oxygen level in the blood and prevent other body organs from failing. To do this, patients definitely need a mechanical ventilator and oxygen therapy .

In addition, doctors do several other things to minimize complications.

• Sedatives are given to control pain and discomfort.
• The patient is turned into a prone position rather than an upright position. This allows oxygen to flow more easily to the lungs.
• Blood thinners are given to prevent blood clots.
• Diuretics are given to remove excess fluid from the body and lungs.
• If there is an infection, antibiotics are given to treat it or prevent infection.
• Physical therapy is used to prevent muscle weakness.

How long does it take to heal and the outlook?

The time it takes depends on the severity of the disease and the speed of lung recovery. Typically, it can take six months to a year for a person to regain their normal lung function after ARDS. However, some people do not fully recover.

Survival rates for ARDS have now increased significantly. If treated early, between 55% and 70% survive. However, this rate decreases if treatment is delayed or if other organs begin to fail.

Recovery is a long journey. Most people are able to breathe on their own after being removed from a ventilator. Some recover completely. Others may have long-term lung problems. They will need to continue to be monitored by a pulmonologist.