JAMA PATIENT PAGE | Critical Illness

Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is a sudden and dangerous illness
that makes it difficult to get enough oxygen.
In ARDS, tiny blood vessels in the lung become leaky, causing fluid
Mechanical Ventilation and
to fill up the smallest air sacs in the lung (called alveoli). This fluid
Acute Respiratory Distress Syndrome (ARDS)
prevents the lungs from effectively providing oxygen to the rest of Many patients who develop ARDS need a ventilator
Ventilator
the body and clearing carbon dioxide out of the lungs. ARDS can be to deliver oxygen to the lungs. A breathing tube
life-threatening; many patients with ARDS require life support with (endotracheal tube) is placed in the patient’s main
airway (trachea) and connected to the ventilator.
a ventilator in an intensive care unit to help them breathe.

ent
Cuff inflation port

From pati
Risk Factors for Development of ARDS

Airflow

Airf tient
Endotracheal tube
Patients get ARDS after developing another sudden medical or sur-

low
pa
gical problem that is often so serious that the patient depends on

To
machines and therapies to keep him or her alive in an intensive care Humidifier
unit (ICU). These conditions include
• Adangerousinfectioninthebody(sepsis)orinthelungs(pneumonia) Vocal cord

• A severe injury or burn requiring critical care Inflated cuff

• Inflammation of the pancreas (pancreatitis)

• Problems from inhaling substances like smoke, chemicals, or vomit Esophagus LUNGS
Trachea
• Other serious illnesses
View From Above
Treatment of ARDS FRONT
ManypatientswhodevelopARDSneedaventilator,amachinethatde- Vocal Patients cannot talk while on a
cords
liversoxygenthroughabreathingtube(endotrachealtube).Somepa- ventilator because the
endotracheal tube passes
tients become so sick that they may need medications that make them between the vocal cords.
Endotracheal
less awake or even paralyze them so the ventilator can be as safe and tube
Patients may be given
usefulaspossible.Somepatientsmayneedtobeturnedinthebedfrom medications, such as sedatives,
theirbacktotheirstomach(placedprone),andthesickestpatientsmay to make them more comfortable
BACK while on a ventilator.
require a machine that takes over the work of their heart and lungs
(extracorporeal membrane oxygenation). Sometimes, even these
measures may not be able to provide enough oxygen to the body, and
if this is the case, organs such as the brain and heart may be damaged.
ARDS is very dangerous. When patients need life support, they FOR MORE INFORMATION

may develop new problems from being so ill and in the hospital. Com- • American Thoracic Society
mon problems are collapsed lung (pneumothorax), infections from www.thoracic.org/patients/patient-resources/resources/acute
-respiratory-distress-syndrome.pdf
any large intravenous catheter or from the ventilator itself, a blood clot
from lying still in the hospital bed, or injury and scarring to the lungs. • Chest Foundation
foundation.chestnet.org/patient-education-resources/acute
Long-term Effects of ARDS -respiratory-distress-syndrome-ards/
More and more patients are surviving ARDS. Patients can have lasting
effectsfrombeingsosick.Mostpatientsfindthattheyareweakandhave To find this and other JAMA Patient Pages, go to the For Patients
collection at jamanetworkpatientpages.com.
breathing problems. Some patients get better over several months,
while others find that they continue to have limitations for the rest of
their lives. Patients and family members may also feel depressed, and
some patients have disturbing memories associated with the trauma
ofbeingsoseriouslyill.ManyARDSsurvivorsneedongoingcare,includ-
ing mental health support and physical or occupational therapy.

Authors: Jennifer P. Stevens, MD, MS; Anica Law, MD; Jaclyn Giannakoulis, MA
Conflict of Interest Disclosures: All authors have completed and submitted the
ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Sources: ARDS Definition Task Force. JAMA. 2012; 307(23):2526.
Piantadosi CA, Schwartz DA. Ann Intern Med. 2004;141(6):460-470.
The JAMA Patient Page is a public service of JAMA. The information and
recommendations appearing on this page are appropriate in most instances, but they
are not a substitute for medical diagnosis. For specific information concerning your
personal medical condition, JAMA suggests that you consult your physician. This page
may be photocopied noncommercially by physicians and other health care
professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

732 JAMA February 20, 2018 Volume 319, Number 7 (Reprinted) jama.com

© 2018 American Medical Association. All rights reserved.

Downloaded From: on 08/06/2018