Patient with Acute Respiratory Distress Syndrome

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What is ARDS?

Acute Respiratory Distress Syndrome (ARDS), also known as non-cardiogenic pulmonary edema, develops in the setting of sepsis, pneumonia, aspiration, trauma, burns, and/or toxic ingestions. Alcoholism further increases the risk of ARDS.

Pathophysiology of ARDS:

The pathophysiology of ARDS involves the release of inflammatory mediators as a result of local or distant tissue injury. These mediators cause alveolar damage, hence, causing leakage of proteinaceous material into the alveoli.

Clinical Findings:

Clinical findings include hypoventilation, tachypnea, tachycardia, fever, and dyspnea.

ARDS Lab Tests:

Arterial blood gas reveals hypoxemia and chest x ray reveals bilateral alveolar infiltrates. Furthermore, the pulmonary capillary wedge pressure is less than 18 mm Hg (which is the normal right atrial pressure), and PaO2/FiO2 ratio is less than 200.

ARDS vs Cardiogenic Pulmonary Edema:

Note that cardiogenic pulmonary edema is clinically similar to ARDS, however, the pulmonary capillary wedge pressure in cardiogenic edema is greater than 18 mm Hg.

ARDS Therapy:

Mechanical ventilation with low tidal volumes and positive end expiratory pressure (PEEP). PEEP levels up to 15 may be required to improve oxygenation.

Additional Reading:

Basic Pulmonology

1. Lung Mechanics
2. Alveolar-Blood Gas Exchange
3. Gas Transport and Regulation of Respiration
4. Four Causes of Hypoxemia
5. Control of Respiration
6. Systemic vs Pulmonary Circulation FAQ
7. Principles of Gas Exchange in Lungs
8. Hypoxia, Hypoxemia & Hemoglobin-Oxygen Saturation Curve
9. FAQ on Mechanics of Breathing
10. FAQ on Control of Breathing
11. Criteria for Transudate Pleural Effusion
12. Light's Criteria for Exudate Pleural Effusion
13. Notes on Lung Sounds
14. Patient with Acute Respiratory Distress Syndrome (ARDS)
15. Management of Acute Deep Venous Thrombosis
16. Notes on Asthma Treatment

Pulmonology Videos

1. Video of Pulmonology Examination in a Clinical Setting

Related Topics

1. Histology of the Respiratory System
2. Upper and Lower Respiratory Disorders
3. Pulmonary Examination for Internal Medicine

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