Acute Respiratory Distress Syndrome

Treatments for ARDS

ARDS, or acute respiratory distress syndrome, is a severe respiratory problem that can lead to a life-threatening illness. Early diagnosis and treatment is essential for stopping ARDS before it becomes so severe that organ damage or death is inevitable. Early diagnosis and treatment is essential to saving the life of the patient diagnosed with ARDS.

Common Treatments For ARDS

Oxygen: Treatment begins by giving a patient oxygen to help maintain adequate levels of oxygen in the bloodstream. This is typically done by intubating the patient and using a ventilator. This enables the patient to breathe, even when they are too weak to breathe on their own, and can deliver more oxygen than is available with a nasal cannula or face mask.

Antibiotics: Antibiotics are given to ARDS patients for infection, such as pneumonia, or other types of infection. Many cases of ARDS start as pneumonia or aspiration pneumonia, making antibiotics essential.

IV Fluids: Fluids play an important role in helping the body support all of its vital functions, but finding the right balance of fluid can be tricky. Too little fluid and the body becomes dehydrated, making it difficult to send enough blood and oxygen to the organs and extremities. Too much fluid can hinder the lung's ability to oxygenate the blood.

Body Positioning: In some cases it can help oxygenation to have the patient lay on their stomach. But, most ARDS patients are so sick that even small changes in position can make their condition worse, which makes pronation by staff very difficult. A bed that turns the patient onto their stomach while allowing IV fluid support and ventilator support to continue is a common part of treatment.

See the RotoProne, a bed used for the treatment of ARDS and other respiratory illnesses. The appearance of the bed is very unusual and can be alarming for family members when they first see their loved one in it.

Inhaled Medications:

Nitric Oxide: Inhaled Nitric Oxide, or INO, is a colorless and odorless gas that's occasionally administered as therapy for ARDS patients. It is given to improve circulation within the pulmonary system, which increases oxygenation. Studies are inconclusive regarding the efficacy of INO.
Albuterol: An inhaled medication, albuterol is typically used to treat asthma symptoms by opening the bronchus. It may be used in the treatment of ARDS to help keep the airways open.

Steroids: The administration of IV steroids to patients who are diagnosed with ARDS is a hotly debated topic in medicine. Doctors are divided on whether or not steroids are an effective treatment for ARDS.

Levophed: This medication is given to improve blood pressure by constricting the blood vessels of the body. Many patients with ARDS have difficulty maintaining their own blood pressure; this medication provides blood pressure support and is the drug of choice for patients who are both septic and having difficulty oxygenating.

Sedatives and Paralytics: Sedatives are given to keep the patient calm and to help them tolerate being on a ventilator, which can cause a great deal of anxiety. Paralytics, or drugs that paralyze most of the muscles of the body, are used when the patient is resisting the ventilator to allow the ventilator to do its work. Paralytics are never used without sedation, but sedation can be used without paralytics.

Surfactant: Surfactant is a material made of fats and proteins that is found on the alveoli (air sacs) of the lungs. The surfactant improves the function of the alveoli, improving oxygenation.

Man made surfactant is often given to premature babies, who may not be producing enough of their own. This same medication is given to ARDS patients in rare cases.

After ARDS

Once a patient is diagnosed with ARDS, the mortality rate climbs to approximately 40%, meaning four out of ten patients diagnosed with ARDS dies. The patients who survive often do so because they were diagnosed early and treated very aggressively with appropriate treatment. While the statistics are grim, ARDS treatment improves each year, with more and more patients surviving.

It is normal to be feel exhausted, short of breath and generally ill after a bout of ARDS. It can take weeks or even months to feel normal, even after discharge from the hospital. For some patients, scarring of the lungs may mean that oxygenation is not as good as it was prior to the illness, causing a feeling of fatigue.

_Sources:

_{Inhaled Nitric Oxide For Adult Respiratory Distress Syndrome. The New England Journal of Medicine. Accessed January 2011. http://www.nejm.org/doi/full/10.1056/NEJM199307153290313}

_{Mortality Rates For Patients With Acute Lung Injury/ARDS Have Decreased Over Time. M. Zambon, J. Vincent. Chest: The Journal of the American College of Lung Physicians. July 2008.}

_{What Is ARDS? National Heart Lung and Blood Institute. Accessed January 2011. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html}