Complications

Complications table
ComplicationTimeframeLikelihood

death

short termmedium

Mortality for patients with ARDS is estimated at 30% to 50%.[35][117]

ventilator-associated pneumonia

short termmedium

Can develop in any patient who requires mechanical ventilation for more than 48 hours.

Signs and symptoms include a new fever, elevated white blood cell count, new infiltrate on chest x-ray, increased or changing pulmonary secretions, and hypotension.

multiple organ failure

short termmedium

In addition to respiratory failure, the most common manifestations in patients with ARDS are renal failure, shock, acute delirium, or coma. Less common are hepatic and hematologic failure.

Treatment includes supportive therapy as well as specific interventions for each organ: mechanical ventilation for respiratory failure, dialysis for renal failure, and vasopressors for hypotension.

pneumothorax

short termlow

Most often a complication due to pulmonary barotrauma. Barotrauma occurred in 13% of patients enrolled in the ARDS Network low tidal volume trial and was associated with higher levels of positive end-expiratory pressure (PEEP).[123]

Signs and symptoms include tracheal deviation, sudden worsening hypoxemia, high peak and plateau pressures on the ventilator, hypotension, and cardiovascular collapse.

Chest x-ray can confirm the presence of a pneumothorax. Treated with insertion of a chest tube.

persistent dyspnea

variablehigh

Persistent dyspnea is particularly present during exercise. A majority of patients who survive ARDS have a mild to moderate decrease in carbon monoxide diffusion in the lung,[121] but steady improvement is seen in the first year.[122]

abnormal lung function

variablemedium

In one study, 40% of patients had either restriction or obstruction 1 year after ARDS,[121] but similar abnormalities were not observed in another study.[122]

reduced quality of life

variablemedium

Studies looking at quality-of-life scores found a reduction in quality of life for at least the first year after surviving ARDS.[121][122]

Use of this content is subject to our disclaimer