Acute respiratory distress syndrome (ARDS): Nursing

Acute Respiratory Distress Syndrome, or ARDS, is a type of severe respiratory condition characterized by severe lung inflammation and noncardiogenic pulmonary edema. As a result, there’s decreased lung compliance, leading to hypoxemia and respiratory failure.

Now, let’s quickly review the respiratory tract, which can be divided into two regions: the upper respiratory tract and lower respiratory tract. The upper respiratory tract includes the nose, nasal cavity, the oral cavity, pharynx, epiglottis, larynx, and the upper part of the trachea; while the lower respiratory tract includes the lower part of the trachea, and the lungs containing the bronchi, bronchioles, alveolar ducts, and finally the alveoli.

Alveoli are tiny air-filled sacs where most gas exchange occurs, so as we breathe, the inhaled oxygen moves from the alveolar sacs into the blood, while the carbon dioxide moves from the blood into the alveolar sacs to be exhaled. Now, the alveoli are lined by two types of alveolar epithelial cells, called pneumocytes. The vast majority are type I pneumocytes, which allow oxygen and carbon dioxide to pass through them. There are also type II pneumocytes scattered around which produce surfactant, an oily secretion that coats the alveoli and prevents their collapse.

Now, ARDS is not a primary lung disease, rather it arises as a complication of a systemic injury that causes widespread inflammation which results in damage to the alveolar-capillary membranes within the lung. So, the most common underlying cause of ARDS is sepsis, which causes inflammation in response to an infection. This infection is most often bacterial, but some cases can be associated with viral infections, such as COVID-19. But other injuries include trauma, severe burns, near-drowning, acute pancreatitis, massive blood transfusions, aspiration of gastric contents, and toxic smoke inhalation, as well as vaping-related injury. The list basically includes any serious injury that directly or indirectly affects the entire body.