ARDS is a serious condition that can be frightening for patients and their loved ones. The outcomes tend to be better in younger patients, trauma patients and when ARDS is caused by blood transfusions. Chances of survival and recovery are better for those who recover before other organs begin to fail. Liver failure, kidney failure and severely decreased blood pressure are some common warning signs of a potentially life-threatening situation. Survivors can recover full or partial lung function due to scarring. Health problems outside of the lung such as muscle weakness or fatigue can persist for as long as a year.
How Is ARDS Treated?
There is no cure for ARDS at this time. Treatment focuses on supporting the patient while the lungs heal. The goal of supportive care is getting enough oxygen into the blood and delivered to your body to prevent damage and removing the injury that caused ARDS to develop.
Ventilator support
All patients with ARDS will require extra oxygen. Oxygen alone is usually not enough, and high levels of oxygen can also injure the lung. A ventilator is a machine used to open airspaces that have shut down and help with the work of breathing. The ventilator is connected to the patient through a mask on the face or a tube inserted into the windpipe.
Prone positioning
ARDS patients are typically in bed on their back. When oxygen and ventilator therapies are at high levels and blood oxygen is still low, ARDS patients are sometimes turned over on their stomach to get more oxygen into the blood. This is called proning and may help improve oxygen levels in the blood for a while. It is a complicated task and some patients are too sick for this treatment.
Sedation and medications to prevent movement
To relieve shortness of breath and prevent agitation, the ARDS patient usually needs sedation. Sometimes added medications called paralytics are needed up front to help the patient adjust to the ventilator. These medications have significant side effects and their risks and benefits must be continuously monitored.
Fluid management
Doctors may give ARDS patients a medication called a diuretic to increase urination in hopes of removing excess fluid from the body to help prevent fluid from building up in the lungs. This must be done carefully, because too much fluid removal can lower blood pressure and lead to kidney problems.
Extracorporeal membrane oxygenation (ECMO)
ECMO is a very complicated treatment that takes blood outside of your body and pumps it through a membrane that adds oxygen, removes carbon dioxide and then returns the blood to your body. This is a high-risk therapy with many potential complications. It is not suitable for every ARDS patient.
Recovering from ARDS
ARDS patients may require ventilation for long periods of time. On average this is seven to 14 days. Beyond this time, doctors may suggest a tube be placed directly into the windpipe through the neck (tracheostomy) by a surgeon. Usually the doctor believes it may take weeks more to recover from ventilator support. This tube can easily be removed once the patient is free of the need for a ventilator. It is important to note that most people survive ARDS. They will not require oxygen on a long-term basis and will regain most of their lung function. Others will struggle with muscle weakness and may require re-hospitalization or pulmonary rehabilitation to regain their strength.
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Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.
Page last updated: November 17, 2022
