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Complications
By Mayo Clinic staffARDS is extremely serious, but thanks to improved treatments, more people are surviving it. However, many survivors end up with potentially serious — and sometimes lasting — complications, including:
- Pulmonary fibrosis. Scarring and thickening of the tissue between the air sacs (interstitium) can occur within a few weeks of the onset of ARDS. This stiffens your lungs, making it even more difficult for oxygen to flow from the air sacs into your bloodstream.
- Collapsed lung (pneumothorax). Usually, a breathing machine called a ventilator is used in the treatment of ARDS to increase oxygen in the body and force fluid out of the lungs. However, the ventilator can cause its own problems. The pressure and air volume of the ventilator can force gas to go through a small hole in the very outside of the lung and out into the pleural space in your chest, causing your lung to collapse. If this happens, your doctor will insert a tube between your ribs into the pleural space to remove the excess air, allowing your lung to reinflate.
- Bacterial infections. Sometimes, the ventilator is attached directly to a tube inserted in your trachea to assist breathing. But this can also make you more susceptible to bacterial infections like pneumonia, which can further injure your lungs. Infections can also occur in other parts of your body, including in your bloodstream, urinary tract and spinal fluid. Some of these infections may be difficult to control if the bacteria have become resistant to commonly used antibiotics. The problem may be compounded even further if ARDS was initially caused by a bacterial infection.
- Abnormal lung function. Many people with ARDS recover most of their lung function within several months to two years, but others may have breathing problems for the rest of their lives. If you have other lung diseases, such as emphysema, you're especially likely to have a difficult time recovering from ARDS. Even people who do well usually have shortness of breath and fatigue and may even need supplemental oxygen in the first months after they leave the hospital.
- Muscle wasting and weakness. If you need to use a ventilator for longer than a week, it can begin weakening your muscles because of nutritional deficiency. Many people recovering from ARDS require physical therapy, both in the hospital and once they're at home, to restore strength and stamina. The extent to which you'll regain full functioning depends on many factors, including weight loss, the length of time you were sedated, the length of time on the ventilator, and the amount of damage to your lungs and other organs.
- Memory, cognitive and emotional problems. Sedatives and low levels of oxygen in the blood can lead to memory loss and cognitive problems after ARDS. In some cases, the effects may lessen over time, but in others, the damage may be permanent. Most ARDS survivors also report going through a period of depression, which for some people is quite severe. If you are a friend or family member of someone who has had ARDS, be alert to symptoms of depression and urge him or her to seek professional help as soon as possible.
References
- What is ARDS? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html. Accessed March 2, 2009.
- Adult (acute) respiratory distress syndrome. American Lung Association. http://www.lungusa.org/atf/cf/%7B7a8d42c2-fcca-4604-8ade-7f5d5e762256%7D/ALA_LDD08_ARDS_FINAL.PDF. Accessed March 2, 2009.
- Deal EN, et al. Role of corticosteroids in the management of acute respiratory distress syndrome. Clinical Therapeutics. 2008;30:787.
- George KJ. A systematic approach to care: Adult respiratory distress syndrome. Journal of Trauma Nursing. 2008;15:19.
- Zambon M, et al. Mortality rates for patients with acute lung injury/ARDS have decreased over time. Chest. 2008;133:1120.
- Leaver SK, et al. Acute respiratory distress syndrome. BMJ. 2007;335:389.
