ARDS (Acute Respiratory Distress Syndrome)

*ARDSfacts Medically Edited by: Melissa Conrad Stöppler, MD

• ARDS, or acuterespiratory distress syndrome, is a lung condition that leads to low oxygen levels in the blood. ARDS can be life-threatening. This is because your body's organs, such as the kidneys and brain, need oxygen-rich blood to work properly.
• 大多数人发展ARDS hospital for other serious health problems. Rarely, people who aren't hospitalized have health problems that lead to ARDS, such as severe肺炎。If you have troublebreathing，立即致电您的医生。如果您的呼吸急促，请致电ambulance或者emergency medical services like 911 immediately.
• Causes of ARDS include infections, injuries, or other conditions that cause the lung's tiny blood vessels to leak more fluid than normal into thelungs' air sacs. This prevents the lungs from filling with air and moving enough oxygen into the bloodstream.
• Some common conditions and factors that cause ARDS aresepsis,肺炎，由于受伤，胸部或头部受伤，有害烟雾或烟雾呼吸以及吸入口腔中呕吐的胃中含量，引起严重的出血。
• Risk factors for ARDS include any condition or illness that can directly or indirectly损伤the lungs.
• The first signs and symptoms of ARDS are feeling like you can't get enough air into your lungs, rapid breathing, and low oxygen levels in the blood. Other signs and symptoms depend on the cause of the condition. They may occur before ARDS develops.
• 您的医生会根据您的medical history，进行身体检查，以及测试的结果。
• ARDS的治疗涉及氧气疗法，液体和药物。治疗是在医院的重症监护室unit. Patients who have ARDS may develop other medical problems while in the hospital. The most common problems are infections,气胸(collapsed lung), lung scarring, andblood clots。ARDS患者的生存率取决于潜在的疾病以及患者的整体健康状况。
• 有些人完全从ARDS中恢复过来。其他人继续遇到健康问题。这些问题可能包括呼吸急促，tiredness和muscle weakness,沮丧，以及记忆和思考的问题。
• You can take steps to recover from ARDS and improve your生活质量。Ask your family and friends to help with everyday activities. Don't smoke and avoidsecondhand smoke和other lung irritants, such as harmful fumes. Go to pulmonaryrehabilitation如果您的医生推荐它。加入ARDS的支持小组。如果您感到沮丧，请向医疗团队寻求帮助。
• ARDS treatment has improved in recent years. As a result, the survival rate for ARDS is improving. Researchers are studying new treatments for the condition.

Acute respiratory distress syndrome（ARDS）是一种严重的肺部疾病，会导致低血氧。发展ARD的人通常由于另一种疾病或重大伤害而生病。在ARDS中，液体在肺的微小气囊内部积聚，surfactantbreaks down. A surfactant is a foamy substance that keeps the lungs fully expanded so that a person can breathe. These changes prevent the lungs from filling properly with air and moving enough oxygen into the bloodstream and throughout the body. The lung tissue mayscar和become stiff.

ARDS may develop over a few days, or it can get worse very quickly. The first symptom of ARDS is usually shortness of breath. Other signs and symptoms of ARDS are low blood oxygen, rapid breathing, clicking, bubbling, or rattling sounds in the lungs when breathing.

ARDS可以在任何年龄发展。为了诊断ARDS，您的医生或您的孩子的医生将进行身体检查，检查患者的病史，测量血液氧气并订购chest X-ray。Supplying oxygen is the main treatment for ARDS. Other treatments help make you more comfortable or aim to eliminate the cause of ARDS. Treatments for ARDS may help prevent serious or life-threatening complications, including organ damage or organ failure.

Signs and symptoms that you are developing or are at risk for ARDS may include:

• 气促
• Fast breathing, or taking lots of rapid, shallow breaths
• Fastheartrate
• Coughingthat produces phlegm
• Blue fingernails or blue tone to皮或者lips
• Fatigue
• 发烧
• Crackling sound in the lungs
• 胸部疼痛, especially when trying to breathe deeply
• 低血压
• 困惑

如果您呼吸困难，请立即致电医生。如果您的呼吸急促，请致电9-1-1。

Many conditions or factors can directly or indirectly injure the lungs and lead to ARDS. Some common ones are:

• 败血症。这是细菌感染血液的疾病。
• 肺炎。这是肺部感染。
• Severe bleeding caused by an injury to the body.
• 胸部或头部受伤,就像一个severe blow.
• Breathing in harmful fumes or smoke.
• 吸入口中呕吐的胃含量。

目前尚不清楚为什么有些病人或严重受伤的人会出现ARDS，而另一些人则没有。研究人员试图找出ARDS为什么发展以及如何预防它。

有ARDS风险的人患有病情或疾病，可能直接或间接伤害其肺部。由于感染，环境暴露，生活方式习惯，您可能会增加ARD的风险遗传学，其他医疗状况或程序，种族或性别。风险因素可能会因您的年龄，整体健康，居住地以及您获得护理的医疗保健环境而有所不同。

感染

感染是ARDS最常见的危险因素。这些可能包括：

• Flu或者other病毒, such as呼吸道合胞病毒和SARS-CoV-2, are the virus responsible forCOVID-19。Watch this video external link to learn more about howCOVID-19影响肺部。此外，我们还提供有关我们如何努力支持必要的Covid-19-19研究的信息和资源。
• 肺炎
• 败血症，是细菌感染血液的疾病
• Uterine infection in the mother, affecting anewborn’s lungs

环境

Being exposed to air pollution for weeks or months can make you more vulnerable to ARDS.

生活方式习惯

Habits that harm the health of your lungs increase your risk of ARDS. These include:

• 大量的酒精使用
• Overdose of illegal drugs
• Smoking

Family history and genetics

The基因您继承可能会使您面临ARDS的风险。这些基因在肺部对损伤的反应中起作用。

Other medical conditions or procedures

Other medical conditions, injuries, or medical procedures can raise your risk for ARDS. These may include:

• 输血s
• Fat embolism，其中脂肪块阻止了动脉。身体伤害，例如broken bone，会导致脂肪栓塞。
• Hemorrhagicshock
• Inhaling呕吐，烟雾，化学烟雾或在接近 -溺水
• Injuries, such as from a blow orburns
• Lung injury from being on aventilator
• Lung or heart surgery, or being placed on a heart-lungbypassmachine
• Newborn lung conditions can raise the risk of your baby havingneonatalARDS。其中包括肺炎和未出生婴儿通过的疾病凳子while still in the子宫,然后吸入他或她的凳子上ngs. Your baby is also at higher risk if he or she did not get enough oxygen during delivery.
• Pancreatitis是胰腺被感染的条件。胰是glandthat releases enzymes and hormones.
• Pulmonaryvasculitis
• Reaction to medicine, such as those used to treatcancer或者arrhythmia

种族或种族

The risk of developing ARDS is higher among nonwhite groups.

Sex

Among children, boys are at a higher risk of ARDS than girls are.

Learn more about how ARDS in newborns is different from respiratory distress syndrome, a similar breathing condition that also affects newborns.

您的医生会根据您的medical history, physical exam, and test results. ARDS can be difficult to diagnose and is often mistaken for another condition, so it is important to know your symptoms.

Medical history

To help diagnose ARDS, your doctor may ask you about any medical conditions or recent events that could be considered risk factors. For example, traveling could be a风险因素because of potential exposure to infections that are more common in certain geographic areas. Your doctor may also ask about your symptoms and whether you have a heart problem, such as心脏衰竭，或其他可能引起与ARDS相似的体征和症状的情况。

体检

Your doctor will examine you for signs of ARDS. This exam may include:

• Listening to your lungs through a听诊器对于异常呼吸声，例如crack啪作响
• 聆听您的心脏快速心律
• Checking for signs that you are having difficulty breathing, such as using muscles in your chest to help you breath
• 检查皮肤或嘴唇是否有蓝色的音调可以指示低血氧水平
• 检查身体是否有肿胀或其他额外液体的迹象，这可能与心脏或肾脏问题有关
• Measuring yourblood pressure和氧气水平

诊断测试和程序

To diagnose ARDS, your doctor may have you undergo some of the following tests and procedures. Different tests may be appropriate for different ages.

• Blood testsmeasure the oxygen level in your blood using a sample of blood taken from an artery. A low blood oxygen level might be a sign of ARDS. In order to confirm the cause of your symptoms, your doctor may also check your blood for signs of infection or a heart problem, or to see how well other organs are working.
• ChestX射线to create detailed images of the inside of your chest. This test is generally the standard for showing excess fluid in your lungs.
• CT(computed tomography)扫描of the chest or abdomen to create detailed images of your lungs or check for abdominal infections.
• Other tests of blood oxygen levels, such as脉冲血氧仪, do not require collecting a blood sample. For these tests, a sensor is attached to the skin or placed on a hand or foot.

测试其他医疗状况

Other tests can help find the cause of your ARDS or determine if there is another type of problem. These include:

• Sputum culture帮助找到感染的原因。该文化用于研究您从肺部咳嗽的痰。
• Bronchoscopy如果没有明显的原因，请诊断肺部问题。作为该测试的一部分，您的医生可能会冲洗肺部以获取细胞并在显微镜或者with other tests.
• Echocardiogram或肺超声。These tests can help your doctor rule out heart failure,congenital heart defects，或其他呼吸问题。
• 肺活检, when other tests do not confirm a diagnosis
• 尿检to detectbacterial infections或排除肾脏问题

ARDS治疗的目的是提高氧气水平并治疗根本原因。其他疗法旨在防止并发症并使您感到舒适。

Breathing support

Oxygen therapy to raise the oxygen levels in your blood is the main treatment for ARDS. Oxygen can be given throughtubesresting in your nose, a face mask, or a tube placed in yourwindpipe。

Depending on the severity of your ARDS, your doctor may suggest a device or machine support your breathing. These include:

• Non-invasiveventilation, such as bilevel positiveairwaypressure (BiPAP) orcontinuous positive airway pressure(CPAP） 设备。这些电子呼吸设备通过将空气吹过面罩，有助于使您的气道保持开放。
• A ventilator。您的医生将调整呼吸机设置，以防止对肺组织的更多损害。如果呼吸机有助于恢复您的血氧水平，并且更容易自行呼吸，则医生可能会关闭呼吸机，以查看是否准备好将其完全清除。有些人从呼吸机过渡到便携式氧疗法。呼吸机的风险包括肺炎和气胸, which can cause your lungs to collapse.

药物

Your doctor may recommend medicine to relieve symptoms, treat the underlying cause, or prevent complications from being in a hospital. These may include:

• 减少酸性药物to preventstressulcers, which can cause bleeding in theintestines。
• Antibioticsto treat or prevent infections. If you are on a ventilator, your healthcare team may do tests, such as lung fluidlab测试或CT scans，寻找新感染的迹象。
• 血液稀释剂阻止血块形成或增长。肝素is a common blood thinner for adults.
• Muscle relaxantshelp prevent coughing or gagging while on a ventilator or reduce the amount of oxygen your body needs.
• Painmedicines, which your doctor may prescribe, depending on your needs.
• Sedatives帮助缓解anxiety，使呼吸器呼吸或降低身体的氧气需求更容易。有时您的医生可能会配对镇静剂with another medicine to make it easier to deliver the oxygen. Complications vary depending on the sedative used, the dose, and how long it is used. They can include沮丧,post-traumatic stress disorder(PTSD），思维或记忆问题，或删除呼吸机的延迟。

Other treatments

Your doctor may recommend other treatments, including:

• 输血低处理血红蛋白levels. Hemoglobin carries oxygen in the blood, so atransfusioncan improve the delivery of oxygen to the body’s organs.
• Extracorporeal membrane oxygenation(ECMO)或者a similar device, especially for severe ARDS. ECMO helps when ventilation alone cannot deliver enough oxygen or while a patient waits for alung transplant。ECMO像人造肺一样工作，去除carbon dioxide并将富含氧气的血液泵回体内。
• Fluid management。Your healthcare team will monitor the fluid balance in your body.低血压当血管中的液体低时，可能会发生。这可能会防止氧气进入您的器官。为了帮助恢复平衡，您的医生可能会通过静脉内（IV）线给您流体。当你有太多fluid in the lungs, your doctor may give you medicines that help your body get rid of it.
• Nutritional support。You may need afeeding tubeto make sure you get enough of the right nutrients while you are on a ventilator.
• Physical therapy保持肌肉力量并防止疮形成。移动可能有助于缩短您在呼吸机上的时间，并在离开医院后改善康复。
• 定位身体。对于严重的ARDS，您的医生可能建议您大部分时间都撒谎，这有助于氧气获得更多的肺部。

If you have ARDS, you can develop other medical problems while in the hospital. Some can be life-threatening. The most common problems are:

• Atelectasisis when small air pockets in thelung collapse
• Complications of treatment in a hospital。Such complications include blood clots that can form from lying down for long periods, weakness in muscles used for breathing or moving around, infections, stress ulcers, and沮丧或其他情绪障碍。思维，记忆和判断问题也可能是由于长期使用镇静剂而引起的。
• Failure of multiple organs。The body’s organs may not work as well or may stop working altogether if they do not get enough oxygen. This lack of oxygen may cause several organs to stop working at the same time, setting up a potentially life-threatening situation.
• Pulmonary hypertension, or an increase in blood pressure in the major artery leading from the heart to the lungs. This condition may occur when the blood vessel narrows as a result of damage from inflammation ormechanical ventilation。ARDS还可能导致在肺部血管中形成微小的凝块。

Learn more about how some people are more at risk of complications from ARDS.

• 一些研究表明，威胁生命并发症的风险可能与种族或种族有关。他们认为，发展ards的非裔美国人和西班牙裔人比白人生存的可能性少。研究还表明，患有ARD的男性比女性更有可能发展生命的问题。

有些人完全从ARDS中恢复过来。其他人继续遇到健康问题。After you go home from the hospital, you may have one or more of the following problems:

• 气促。After treatment, many people who have ARDS recover close-to-normal lung function within 6 months. For others, it may take longer. Some people have breathing problems for the rest of their lives.
• Tiredness and muscle weakness.Being in the hospital and on a ventilator (a machine that supports breathing) can cause your muscles to weaken. You also may feel very tired following treatment.
• 沮丧。许多人在治疗后一段时间感到沮丧的人。
• Problems with memory and thinking clearly.Certain medicines and a low blood oxygen level can cause these problems.

These health problems may go away within a few weeks, or they may last longer. Talk with your doctor about how to deal with these issues. Also, see the suggestions below.

得到帮助

您可以采取步骤从ARDS中恢复并改善生活质量。例如，向您的家人和朋友寻求日常活动的帮助。

如果您抽烟，请退出。Smokingcan worsen lung problems. Talk to your doctor about programs and products that can help you quit. Also, try to avoidsecondhand smoke和other lung irritants, such as harmful fumes.

If you have trouble quitting抽烟on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help peoplequit smoking。

去肺部康复（rehab) if your doctor recommends it. Rehab might includeexercise培训，教育和咨询。康复可以教您如何恢复正常活动并保持活跃。

Your rehab team might include doctors, nurses, and other specialists. They will work with you to create a program that meets your needs.

情绪问题和支持

与Ards一起生活may cause fear, anxiety, depression, and stress. Talk about how you feel with your health care team. Talking with a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.

Joining a patient support group may help you adjust to living with ARDS. You can see how other people who have the same symptoms have coped with them. Talk to your doctor about local support groups or check with an area medical center.

家人和朋友的支持也可以缓解压力和焦虑。让您的亲人知道您的感受以及他们可以做什么来帮助您。

现在，人们比过去更多的人幸存下来。这样做的一个可能是，对病情的治疗和护理有所改善。ARD的存活率因年龄，ARDS，相关疾病和其他因素的根本原因而异。一些研究估计mortality ratefor ARDS is 36% to 52% per 100,000 people, depending upon their current health condition.

Some people who survive recover completely. Others may have lasting damage to their lungs and other health problems.

Researchers continue to look for new and better ways to treat ARDS.

• Acute lung injury
• Adult respiratory distress syndrome
• Increased-permeabilitypulmonary edema
• 非心脏pulmonary edema
• ARDS used to be called僵硬的肺,shock lung, andwet lung。