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Acute respiratory distress syndrome (ARDS)

Last reviewed: 5 Sep 2024
Last updated: 31 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • low oxygen saturation
  • acute respiratory failure
Full details

Other diagnostic factors

  • critically ill patient
  • dyspnea
  • increased respiratory rate
  • pulmonary crepitations
  • low lung compliance
  • fever, cough, pleuritic chest pain
  • frothy sputum
Full details

Risk factors

  • sepsis
  • aspiration
  • pneumonia
  • severe trauma
  • blood transfusions
  • lung transplantation
  • pancreatitis
  • history of alcohol misuse
  • burns and smoke inhalation
  • drowning
  • e-cigarette and vaping product use
  • Immunotherapy
  • drug overdose
  • cigarette smoking
Full details

Diagnostic tests

1st tests to order

  • chest x-ray
  • arterial blood gases
  • sputum culture
  • blood culture
  • urine culture
  • amylase and lipase
Full details

Tests to consider

  • brain natriuretic peptide (BNP)
  • echocardiogram
  • pulmonary artery catheterization
  • bronchoalveolar lavage or endotracheal aspirate
  • CT scan of the thorax
  • Lung ultrasound
  • viral testing
  • open lung biopsy
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Lorraine B. Ware, MD
Lorraine B. Ware

Ralph and Lulu Owen Professor of Medicine

Professor of Pathology, Microbiology and Immunology

Director

Vanderbilt Medical Scholars Program

Division of Allergy, Pulmonary and Critical Care Medicine

Department of Medicine

Vanderbilt University School of Medicine

Nashville

TN

Disclosures

LBW has received consulting fees from Arrowhead, Akebia, Santhera, and Global Blood Therapeutics, all unrelated to the topic of this article. LBW has received research funding (to her institution) from the US National Institutes of Health, Boerhinger Ingelheim, and Genetech Inc., unrelated to the topic of this article. LBW holds stock in Virtuoso Surgical, unrelated to the topic of this article.

Acknowledgements

Dr Lorraine Ware would like to gratefully acknowledge Dr Richard Fremont, a previous contributor to this topic.

Disclosures

RF declares that he has no competing interests.

Peer reviewers

Michael A. Matthay, MD

Director of Medicine Critical Care Fellowship

Department of Anesthesia and Perioperative Care

University of California San Francisco

CA

Disclosures

MAM declares that he has no competing interests.

Timothy Evans, MBBS

Professor of Intensive Care Medicine

Royal Brompton Hospital

London

UK

Disclosures

TE declares that he has no competing interests.

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