How Is ARDS Diagnosed?

Your doctor will diagnose ARDS based on your medical history, a physical exam, and results from tests.Your doctor will ask about conditions you may have or have recently had that could lead to ARDS. Your doctor also will ask whether you have heart problems, such as heart failure, which can cause fluid to build up in your lungs.

 

ARDS is not a specific disease; instead, it is a type of severe, acute lung dysfunction that is associated with a variety of diseases, such as pneumonia, shock, sepsis and trauma. ARDS can be confused with congestive heart failure, which is another common condition that can also cause acute respiratory distress.

 

Physical Exam

ARDS may cause abnormal breathing sounds, such as crackling. Your doctor will listen to your lungs with a stethoscope to hear these sounds. He or she also will listen to your heart and look for signs of extra fluid in other parts of your body. Extra fluid may mean you have heart or kidney problems. Your doctor will look for a bluish color on your skin and lips. A bluish color means your blood has a low level of oxygen. This is a possible sign of ARDS.

 

Diagnostic Tests

Diagnostic tests are used to find the cause of your symptoms. You may have ARDS or another condition that causes similar symptoms.

 

Initial Tests

Other tests used to diagnose ARDS include:

 

 

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How Is ARDS Treated?

ARDS is treated with oxygen therapy, fluids, and medicines. Treatments are done in a hospital's intensive care unit.The main goals of treating ARDS include getting oxygen to your lungs and organs and treating the underlying condition that's causing ARDS.

 

Oxygen Therapy

First, your doctor will try to give you extra oxygen. Oxygen is given through a mask that fits over your mouth (or mouth and nose).

 

If your oxygen level doesn't increase or it's still hard for you to breathe, your doctor will give you oxygen through a breathing tube. The flexible tube will be inserted through your mouth or nose and into your windpipe.

 

Before inserting the tube, your doctor will squirt or spray a liquid medicine into your throat (and possibly your nose) to make it numb. This helps prevent coughing and gagging when the tube is inserted. Your doctor also will give you medicine through an intravenous (IV) line into your bloodstream to make you sleepy and relaxed.

 

The breathing tube will be connected to a machine that helps you breathe. The ventilator will fill your lungs with oxygen-rich air.

 

Your doctor will adjust the ventilator as needed to help your lungs get the right amount of oxygen.

 

This also will help prevent injury to your lungs from the pressure of the ventilator.

 

The breathing tube and ventilator are used until you can breathe on your own. If you need a ventilator for more than a few days, your doctor may do a tracheotomy.

 

This procedure involves making a small cut in your neck to create an opening to the windpipe. The opening is called a tracheostomy.Your doctor will place the breathing tube directly into the windpipe. The tube is then connected to the ventilator.

 

Fluids may be given to improve the flow of blood through your body and to provide nutrition. Your doctor will make sure you get the right amount of fluids.

Too much fluid can fill the lungs, making it harder to get the oxygen you need. Not enough fluid can limit blood and oxygen flow to the body's organs. Fluids usually are given through an IV line inserted in one of your blood vessels.

 

Medications are used to reverse the underlying condition if possible, to prevent and treat complications of critical illness, and to alleviate patient distress, such as pain, air hunger, anxiety and severe confusional states. Antibiotics are commonly used to treat confirmed or suspected infections. Vasopressors such as dopamine or Neosynephrine may be needed to maintain adequate blood pressure. Pain relievers such as morphine and fentanyl and anti-anxiety drugs such as Ativan or Versed are usually required to improve patient tolerance of mechanical ventilation. Other medications may be used to prevent bleeding from the stomach or to reduce the risk of blood clot formation in the veins of the legs or arms. After the first 2 or 3 days, patient nutrition is resumed, if possible. Until the patient can eat again by mouth, food is given in liquid form into a central vein or into the stomach or intestine through a feeding tube. If liquid feeding is required for longer than one or two weeks, a surgical procedure may be performed to place a tube through the abdominal wall directly into the stomach or intestine.

 

Your doctor may give you medicines to prevent and treat infections and to relieve discomfort.

Complications From ARDS

If you have ARDS, you can develop other medical problems while in the hospital. The most common are infections, pneumothorax, lung scarring, and blood clots.