Acute Respiratory Distress Syndrome (ARDS)
Adult respiratory distress syndrome describes the respiratory failure caused by acute lung injury. Bird Flu infection can lead to ARDS. The exchange of carbon dioxide and oxygen is reduced due to inflammation and the accumulation of fluid in the air sacs (aveoli) in the lungs. There is no simple treatment for this life threatening condition.
from Professional Guide to Diseases from Lippincott Williams & Wilkins…
What Happens in ARDS This flowchart shows the process and progress of acute respiratory distress syndrome (ARDS).
- Injury reduces normal blood flow to the lungs, allowing platelets to aggregate.
- These platelets release substances, such as serotonin, bradykinin and, especially, histamine. These substances inflame and damage the alveolar membrane and later increase capillary permeability. At this early stage, signs and symptoms of ARDS are undetectable.
- Histamine and other inflammatory substances increase capillary permeability, allowing fluid to shift into the interstitial space. As a result, the patient may experience tachypnea, dyspnea, and tachycardia.
- As capillary permeability increases, proteins and more fluid leak out, increasing interstitial osmotic pressure and causing pulmonary edema. At this stage, the patient may experience increased tachypnea, dyspnea, and cyanosis. Hypoxia (usually unresponsive to increased fraction of inspired air), decreased pulmonary compliance, and crackles and rhonchi may also develop.
- Fluid in the alveoli and decreased blood flow damage surfactant in the alveoli, reducing the cells’ ability to produce more. Without surfactant, alveoli collapse, impairing gas exchange. Look for thick, frothy sputum and marked hypoxemia with increased respiratory distress.
- The patient breathes faster, but sufficient oxygen (O2) can’t cross the alveolocapillary membrane. Carbon dioxide (CO2), however, crosses more easily and is lost with every exhalation. O2, and CO2, levels in the blood decrease. Look for increased tachypnea, hypoxemia, and hypocapnia.
- Pulmonary edema worsens. Meanwhile, inflammation leads to fibrosis, which further impede, gas exchange. The resulting hypoxemia leads to metabolic acidosis. At this stage, look for increased partial pressure of arterial carbon dioxide, decreased pH and partial pressure of arterial oxygen, and mental confusion.
In order to hasten the development of effective therapy for Acute Respiratory Distress Syndrome (ARDS), the National Heart, Lung, and Blood Institute, National Institutes of Heath, initiated a clinical network to carry out multi center clinical trials of ARDS treatments. The goal of the Network is to efficiently test promising agents, devices, or management strategies to improve the care of patients with ARDS. This site has link to network institutions, studies and publications.
The ARDS Foundation is a National Not for Profit Organization composed of a group of individuals who have been personally affected by ARDS (acute respiratory distress syndrome). We are dedicated to increasing public awareness, education, and financial assistance to those engaged in medical research. Here you’ll find latest breaking news and events from ARDS Foundation, links and resources to ARDS related sites, and medical research.
Acute Respiratory Distress Syndrome Support Group
The primary purpose of the ARDS Support Center is to provide information, education, care and support for patients, survivors, family members and loved ones who have been confronted with the many problems resulting from the onset, treatment and consequences of the devastating condition known as Acute Respiratory Distress Syndrome. The ARDS Support Center will sponsor and participate in activities aimed at funding ARDS research, the furtherance of the primary goal of the ARDS Support Center and creating a broad public awareness of this deadly syndrome.
- Provide highly reliable authenticated medical information relating to the nature and treatment of ARDS and post-ARDS conditions that may develop.
- Provide a staff of volunteers who will assist those seeking care, support and information from the ARDS Support Center.
- Provide facilities that will assist individuals in coping with the onset, treatment and consequences of ARDS.
Suctioning of the patient in the home American Association for Respiratory Care, Clinical Practice Guideline
An Introduction to Postural Drainage & Percussion Cystic Fibrosis Foundation 8 page pdf
Nursing patients with ARDS in the prone position. Nursing Standard magazine, Royal College of Nursing UK
An Introduction to Airway Clearance Techniques Cystic Fibrosis Foundation 2 page pdf
Acute Lung Injury and Adult Respiratory Distress Syndrome
American Society of Anasthesiologists annual meeting 2005, Avery Tung, MD
Home Ventilation using CPAP discussion on the FluWIki
The essential fatty acids flax seed and fish oil (Eicosapentaenoic acid EPA ), evening primrose, and borage seed oil (Gammalinoleic acid GLA) supplements are reported to reduce lung damage and need for mechanical ventilation in ARDS patients. An article in the Wall Street Journal April 4, 2006 describes how statins, albuterol, and lipids have been found to reduce the damage caused by ARDS. It is discussed here. The topic of cytokine storm and ARDS is also discussed here.
http://www.curevents.com/vb/showthread.php?t=27044 Cytokine Storm and ARDS on the FluClinic has a lot of information we should add to this page.