Acute Respiratory Distress Syndrome

ARDS or acute respiratory distress syndrome is a severe respiratory disorder caused by a buildup of fluid in the alveoli or the small air sacs in the lungs. The main symptoms are severe shortness of breath and difficulty breathing.

ARDS is often caused by a critical illness, such as sepsis or severe pneumonia. One of the causes of pneumonia which is currently becoming a pandemic is the Corona virus (COVID-19). According to a number of studies, some COVID-19 patients may develop ARDS in the course of their illness.

ARDS is an emergency condition that threatens the life of the sufferer, so it needs to be treated quickly and appropriately.

Penyebab Acute Respiratory Distress Syndrome

ARDS is caused by damage to the alveoli due to the seepage of fluid from the capillaries in the lungs into the alveoli. Alveoli are air sacs in the lungs that function to deliver oxygen to the blood and remove carbon dioxide from the blood.

Under normal conditions, the membrane that protects the capillaries keeps fluid in the blood vessels. However, in ARDS, severe injury or illness causes damage to these protective membranes, allowing fluid to leak into the alveoli.

This buildup of fluid makes the lungs unable to fill with air, so the supply of oxygen to the bloodstream and body is reduced. This lack of oxygen supply will cause the cessation of organ function, including the brain and kidneys. If left unchecked, this condition will threaten the life of the sufferer.

Some of the conditions and diseases that can cause ARDS are:

• Sepsis
• Injuries to the head or chest, for example from a collision or accident
• Severe pneumonia (lung infection)
• Burns
• Inhalation of harmful substances, such as concentrated fumes or chemical fumes
• Choking or near drowning
• Receiving a blood transfusion with a large volume of blood
• Pancreatitis

Faktor Risiko Acute Respiratory Distress Syndrome

There are several factors that can increase a person's risk of ARDS, including:

• Over 65 years old
• Have a smoking habit
• Have an alcohol addiction
• Suffering from chronic lung disease
• Suffering from genetic disorders
• Suffering from obesity
• Experiencing an overdose of certain drugs

Gejala Acute Respiratory Distress Syndrome

Symptoms of ARDS can vary for each sufferer, depending on the cause, severity, and whether there are other illnesses, such as heart disease or lung disease.

Some of the symptoms and signs that can appear in people with ARDS are:

• Short and fast breath
• Hard to breathe
• Low blood pressure ( hypotension )
• Body feels very tired
• Excessive sweating
• Blue lips or nails ( cyanosis )
• Chest pain
• Increased heart rate ( tachycardia )
• Cough
• Fever
• Headache or dizziness
• Confused

Diagnosis Acute Respiratory Distress Syndrome

The doctor will ask about the patient's symptoms and medical history, followed by a physical examination. Physical examinations carried out included examination of vital signs, such as respiratory rate or frequency, blood pressure, pulse, temperature, and bluish color of the lips and nails, and a physical examination of the chest wall .

To confirm the diagnosis and cause, the doctor will perform a number of examinations below:

• Blood tests , to measure oxygen levels in the blood ( blood gas analysis ) and check for anemia or infection
• Chest X-ray , to see the location and amount of fluid buildup in the lungs, as well as detect the possibility of an enlarged heart
• CT scan , to see the condition of the lungs and heart with a more detailed picture
• Echocardiography (ultrasound of the heart), to assess the condition and structure of the heart and detect the presence or absence of heart function disorders
• Electrocardiogram (ECG), to see the electrical activity of the heart and rule out symptoms caused by heart disease
• Culture or examination of sputum samples, to determine bacteria or other microorganisms that cause infection
• Biopsy or sampling of tissue from the lungs, to rule out symptoms caused by lung diseases other than ARDS

Pengobatan Acute Respiratory Distress Syndrome

ARDS treatment aims to increase oxygen levels in the blood so that the patient's organs function normally and avoid organ failure. Another goal of ARDS treatment is to relieve symptoms and prevent complications.

Some of the methods for dealing with ARDS are:

• Provide oxygen assistance through a nasal tube or mask for patients with mild symptoms
• Installing breathing apparatus and ventilators to help deliver oxygen to the lungs
• Giving fluids through an IV
• Provide nutritional intake using a nasogastric tube inserted through the nose
• Give antibiotics to prevent and treat infections
• Give blood thinners to prevent blood clots in the legs and lungs
• Giving pain medication, medication to reduce stomach acid, and medication to relieve anxiety

For ARDS patients who are recovering, it is recommended to undergo pulmonary rehabilitation. This action aims to strengthen the respiratory system and increase lung capacity.

Komplikasi Acute Respiratory Distress Syndrome

People with ARDS can experience complications, both as a result of ARDS itself and as a side effect of treatment. Some of these complications are:

• DVT ( d eep vein thrombosis ) or blood clots in the veins in the limb due to lay a continuous
• Pneumothorax or accumulation of air in the pleural membrane, generally occurs due to air pressure from the use of a ventilator
• Lung infection due to the entry of germs into the lungs through breathing apparatus
• Pulmonary fibrosis or the formation of scar tissue in the lungs that makes it more difficult for the lungs to supply oxygen to the blood

In addition to the above complications, ARDS sufferers who manage to recover can experience long-term health problems, such as:

• Respiratory disorders, such as shortness of breath, so that the patient requires oxygen assistance in the long term
• Impaired thinking and memory due to brain damage
• Weakness and muscle atrophy due to prolonged inactivity (in patients who have to lie down for a long time)
• Depression

Pencegahan Acute Respiratory Distress Syndrome

There are several things that can be done to reduce the risk of ARDS, namely:

• Quit smoking and stay away from exposure to cigarette smoke
• Stop consuming alcoholic beverages
• Undergo flu immunization every year and PCV immunization every 5 years to reduce the risk of lung infections