Essay Sample on Acute Respiratory Distress Syndrome: A Life-Threatening Lung Injury

Introduction

Acute Respiratory Distress Syndrome (ARDS) is an inflammatory lung injury that affects the normal function of the lungs: - gaseous exchange, due to hypoxemia and stiff lungs (Des Jardins & Burton, 2019). This condition affects the ability of the lungs to take up oxygen as a result of the widespread injury on the organ, thus, making breathing difficult or impossible. A low oxygen level in the blood and the inability to return oxygen to normal is the hallmark of ARDS (Kacmarek, Stoller, & Heuer, 2016). Studies have shown that the severity of ARDS is due to its ability to cause immediate deaths of most patients, especially in the absence of mechanical ventilation.

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According to Rawal, Yadav, and Kumar (2018), this condition starts by damaging the alveolar-capillary. It then proceeds to another stage known as lung resolution, and, finally, fibro-proliferate phase, which leads to the damage of pulmonary epithelial and endothelial walls (Des Jardins & Burton, 2019). The damage of these walls results in inflammation, necrosis, apoptosis, and increased alveolar-capillary, causing alveolar edema (Thompson, Chambers, & Liu, 2017). Simply stated, ARDS is an acute life-threatening inflammatory lung damage manifested by stiff lungs and hypoxia as a result of increased pulmonary vascular permeability, resulting in respiratory insufficiency.

Causes

The primary cause of ARDS is the damage of the tiny blood vessels in the lungs. This damage causes the fluids to fill up the airs sacs in the lungs. Excess fluids in the lungs reduce the amount of oxygen and increase the amount of Carbon dioxide in the bloodstream (Des Jardins & Burton, 2019). Factors that lead to this damage include severe blood infection; inhalation of toxic substances like chemicals, salt water, vomit, and smoke; severe infection of lungs including pneumonia; overdosing on sedatives; and head or chest injury (Kacmarek, Stoller, & Heuer, 2016). Individuals at risk of underlying diseases associated with the syndrome can also develop ARDS.

The most common disease is sepsis, a severe infection that spreads all over the body through the bloodstream (Rawal et al., 2018). It also makes the immune system to go overdrive, causing inflammation, bleeding, and small blood clots (Rezoagli, Fumagalli, & Bellani, 2017). Trauma, near drowning, inflammation of the pancreas, medication reactions, burns, blood transfusion and aspiration of the stomach contents into the lungs also increases the chances of ARDS (Thompson et al., 2017). In some parts of the world, malaria is the most common cause of ARDS, although it does not exist in most regions around North America.

Prevalence

Several studies have demonstrated that patients with ARDS represent about 5% of hospitalized, mechanically ventilated population. According to Thompson et al. (2017), 25% of patients have mild conditions, whereas patients with moderate or severe ARDS makes up to 75% of the population. Cases of ARDS vary widely in population-based studies between different continents. Population-based estimates of this condition range from 10 to 86 cases per 100,000, with the highest rates reported in the United States and Australia (Rezoagli et al., 2017). Evaluations from cohort studies using the definition of the American-European Consensus Conference (AECC) showed that South America has approximately 10 cases per 100,000 populations in one year (Rezoagli et al., 2017).

In Europe, nearly 18 patients in a population of 100,000 develop ARDS every year. Australia has recorded about 34 cases of ARDS in a population of 100,000 per year (Rawal et al., 2018). In the United States, approximately 79 people in a population of 100,000 develop ARDS every year (Rezoagli et al., 2017). About 59 of them have developed a severe form of this condition (Rezoagli et al., 2017). Thompson et al. (2017) found that the mortality rate of ARDS patients has reached about 38.5% in the US. More than 74,000 deaths caused by ARDS have been reported in the US (Rawal, et al., 2018). This makes ARDS one of the major causes of deaths in the country, although many citizens are not well-informed of the condition.

In nations of the same continents such as Europe, the occurrence of ARDS varies consistently, ranging from about 11 cases in Finland, 18 in Scandinavia and 26 in France, all in a population of 100, 00 per year (Thompson et al., 2017). The reasons for these wide variations in the cases of ARDS are unclear, but some researchers have linked them to differences in healthcare delivery systems and demographics. Based on the data, the prevalence rate of ARDS is high in the United States than in other countries. The condition is likely to be underreported in low-income nations due to limited resources used to obtain chest radiographs and measure arterial blood gases.

Diagnosis

Diagnosis for ARDS includes physical examination and blood pressure readings. The following tests also aid in diagnosis: blood test, a chest X-ray, a CT scan, an electrocardiogram, throat and nose swabs, an echocardiogram and an airway examination (Des Jardins & Burton, 2019). The physician may depend on an electrocardiogram and echocardiogram to determine a heart condition. Diagnosis is confirmed if a CT scan or chest X-ray indicates the presence of fluid-filled air sacs in the lungs.

Symptoms

• Severe shortness of breath
• Chest pain during inhalation
• Increased heart rates and rapid breathing
• Low blood pressure
• Discolored skin, nails or lips due to low oxygen levels in the blood
• Muscle fatigue and general weakness
• A dry hacking cough
• Mental confusion
• Signs
• Low blood pressure
• Low blood oxygen

Treatment

Treatment involves supportive therapy, pharmacological therapy, fluid management, and pulmonary rehabilitation Rawal et al., (2018). Supportive therapy for ARDS focuses on reducing lung injury through a combination of two mechanisms. The first one is the use lung-protective ventilation to prevent ventilator-associated lung injury while the second measure is the application of conservative fluid therapy to prevent the formation of lung edema (Rezoagli et al., 2017).

Pharmacological therapy includes inhaled nitric oxide and Glucocorticoids (Rezoagli et al., 2017). Inhaled nitric oxide temporarily improves oxygenation and functioning of the lungs among survivors. Glucocorticoids promote oxygenation and airway pressures. In Patterns of pneumonia, it speeds up radiography. Medication can also be used to deal with the side effects of ARDS. Some of them include pain medication to relieve discomfort, blood thinners to prevent clotting of blood in the lungs, and antibiotics to treat an infection (Thompson et al., 2017).

Pulmonary rehabilitation is also an imperative treatment strategy. It is a way of strengthening the respiratory system and enlarging the size of the lungs. Such programs include physical exercise and lifestyle classes (Des Jardins & Burton, 2019). Fluid also serves as a suitable treatment plan. It ensures appropriate fluid balance in the body. Excess fluids can result in fluid buildup in the lungs. Too little fluids can lead to the straining of the heart and organs.

Conclusion

It is now believable that ARDS is a deadly form of respiratory failures accompanied by severe effects. A much more cognizance of the causes and impacts of ARDS should lead the way to appropriate treatment strategies. Supportive therapies demonstrate the foundation of treatment of ARDS. Pharmacological and pulmonary rehabilitation strategies, as well as appropriate fluid management, also generate positive outcomes.

References

Des Jardins, T., & Burton, G. G. (2019). Clinical Manifestations & Assessment of Respiratory Disease E-Book. Amsterdam: Elsevier Health Sciences.

Kacmarek, R. M., Stoller, J. K., & Heuer, A. (2016). Egan's Fundamentals of Respiratory Care-E-Book. Amsterdam: Elsevier Health Sciences. https://www.elsevier.com/books/egans-fundamentals-of-respiratory-care/kacmarek/978-0-323-34136-3

Rawal, G., Yadav, S., & Kumar, R. (2018). Acute respiratory distress syndrome: An update and review. Journal of internal translational medicine, 6(2), 74-77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032183/

Rezoagli, E., Fumagalli, R., & Bellani, G. (2017). Definition and epidemiology of acute respiratory distress syndrome. Annals of translational medicine, 5(14), 282. https://www.nejm.org/doi/full/10.1056/NEJMra1608077

Thompson, B. T., Chambers, R. C., & Liu, K. D. (2017). Acute respiratory distress syndrome. New England Journal of Medicine, 377(6), 562-572. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537110/