Acute respiratory distress syndrome

What is Acute respiratory distress syndrome?

Acute respiratory distress syndrome" ("ARDS"), previously known as "respiratory distress syndrome" ("RDS"), "adult respiratory distress syndrome", or "shock lung", is a severe, life-threatening medical condition characterized by widespread inflammation in the lungs. Although it can be triggered by a primary respiratory infection, such as pneumonia, it is more often a sequelae of sepsis or significant trauma

Questions and answers on "Acute respiratory distress syndrome"

Hi Doctor ,

My mother 56 years of age was suffering from fever and breathless XXXXXXX yesterday she was diagnosed with H1N1 .enclosing her test report . doctor has shifter her to RCU. Do you think there was need to shift to RCU and is case critical. as per doctor she is breathing with 2 liter oxygen.

doctor1 MD

Brief Answer:
Yes, she should be treated in ICU only.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the images you have attached.
Swine flu infection in old age can deteriorate rapidly (within hours). It causes bilateral severe pneumonia...

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My elderly father was diagnosed with aspiration pneumonia after we got him to the hospital within a few hours of the incident....he was on a stomach feeding tube. He was doing well over the next 48 hours per the MD. Then we were told again by the MD that the pneumonia had
spread to both lungs because THEY gave him too much fluid. He died less than 2 weeks later. What happene

doctor1 MD

Brief Answer:
Aspiration leading onto ARDS

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Sorry to know about your father.

Based on your query, my opinion is as follows:

1. Aspiration would have led to lung injury.
2. Secondary to lung injury,...

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Dear Sir / Madam,

A 44 year’s male patient a case of renal transplant recipient on immunosuppressant, BREATHLESSNESS FOR EVALUATION- LRTI VS PULMONARY EDEMA POST RENAL TRANSPLANT WITH ALLOGRAFT DYSFUNCTION ON IMMUNOSUPRESSANT / BA / S/P CLIPPING FOR ANEURYSM.

Patient was admitted with the c/o shortness of breath - about 2 hrs prior to presentation to ER ... insidious in onset and gradually progressed c/o fever..moderate grade - in the evening 0n 14-4-16 relieved with medications (101.5 F at home had taken tab DOLO 650 mg ), not assocaited with chills or rigors c/o cough sinc the past 1 week , initially dry but has been productive since 2 days, whitish sputum , ? blood tinged c/o b/l lower limb swelling since 1 week which has gradually increased , more in the evening and has increased since the last 2 days recent h/o travel in the month of feb 2016 no c/o chest pain/ palpitations, no c/o burning while passing urine / increased frequency of micturition, no c/o dizziness, no othr systemic complaints post renal transplant (June 2015) with allograft dysfunction had recent admission for rising creatinine and acute rejection of graft. Pt was discharged on 09/04/16 with Creatinine of 3.9 /Urea:96.Pt had intermittent h/o tachypnea.Now again readmitted with c/o fever and shortness of breath.In ER pt was tachypnic/tachycardiac,desaturating to unsafe levels on room air. ECG - sinus rhythm Trop-I 0.21 the pateient was started on NIV - in view of pumonary edema -with CPAP - FiO2- 90% - down tirated to 70% peep -9 RR -14 BP - reemained elevated at 190/100 - inj NTG - increased to 20mcg/min inj lasix 40+40 given He was shifted to ICU for further management .

In the ICU , he was optimized by initiating on NIV.CXR:B/L Haziness++.Right Triple lumen Femoral venous cannulation was done. Repeat ABG showing worsening of acidosis.Pt was initiated on HD immediately. He was continued on intermittamnt NIV and other supportive measures .He gradually improved breathing comfortably ,haemodynamically stable.Pulmonology opinion was taken . He was shifted to wards for further management . He was doing well inthe wards. He underwent Cardio-Pulmonary Sleep study - Shows severe OSA with RDI of 95/hr with lowest oxygen saturation of 81% and longest apnea of 46 sec. Lowest HR of 44 and highest HR of 126 was noted during this study. CXR - Shows persisting bil infiltreates inspite of regular MHD He underwent HRCT Chest to r/o primary lung issues- showed Patchy areas of consolidation noted in the left superior, posterobasal, laterobasal segments of the left lung
posterobasal segment of the right lower lobe, and anterior segment of the right upper lobe along the major fissure. Ground glass opacities and nodules tree in bud appearance noted in the anteroposterior segment of the right upper lobe, superior segment of the bilateral lower lobe. Focal consolidation with cavitation in the right upper lobe. He underwent Bronchoscpy and lavage on 25/4/16- to rule out TB/ fungal infection. He was continued on septran and other antibiotics . On 26/4/16, Mr. XXXXXXX Shah was shfted from the ward gasping for breath, tachypneic(RR-52/min), tachycardic(140/min) and hypoxemic (spo2 80%). awake & not able to talk due to breathlessness. Immediately was put on NIV, 100%Fio2.Nephro team have started him on dialysis. He continues to remain breathlesss & tachypneic. remained hypotensive, not breathing well.. Intubated & ventilated. size 8.5, connected to ETT. Cntinued dilaysis. around 15min later, developed bradycardia & hypotension.(HR 38/min) adrenaline boluses given, CPR initiated & patient had ROSC after 2cycles of CPR. family called in, spoke to Yogesh(brother ) about the deterioration XXXXXXX showed AFB- started on Antitubercular drugs along with broad spectrum antibiotics . He remained very critical , remained hypotensive and acidotic despite of all the resuscitative measures .He had sudden cardiac arrest at 9am , could not be revived and declared dead at 9.30am on 27/4/16.

Kindly suggest cause of Death in this case, is it on account of renal transplantation rejection or on account of Tuberculosis.

doctor1 MD

Brief Answer:
Explanation provided.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I am sorry for your loss. I have gone very carefully through the details provided. It is quite clear that he had respiratory distress syndrome which was associated with pneumonia. The pneumonia would have...

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Extensive inhomogeneous opacification noted at both lung fields, sparing some upper zones indicating bilateral consolidation

doctor1 MD

Brief Answer:
Possibility of bilateral extensive pneumonia is more likely.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
By your x ray description, possibility of bilateral extensive pneumonia is more likely.
Such pneumonia are seen with
1. Viral...

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I took my son in who just got back from a XXXXXXX Hosp. where he was diagnosed with pneumonia
He is sleeping constantly and taking vitamins and lots of liquids and meals
His perscriptions were lost. What should we do? He is homeless and penniless and all I can do
is take care of him. Is he in immediate danger? We will probably go to our Bradenton hospital
in the A.M/ He did not want to go over the long weekend and have to sit for hours, he feels too bad.

doctor1 MD

Brief Answer:
Get a refill, supportive measures till then

Detailed Answer:
Thank you for asking!
Pneumonia is common pathologic infection of the lungs and is treatable easily with antibiotics and would have been a dangerous situation if the age was advanced or immune status was debilitated.
As...

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Hello, xray shows large and dense opacity in right lower lobe with costophrenic angle suggestive of consolidation with pleural effusion rest of the lung shows increased broncho vascular markings and intestitial shadows.Please can u tell me what is the diagnosis for this

doctor1 MD

Brief Answer:
Please upload Page 2 of CT Scan report

Detailed Answer:
Hi Ms. Kaveeta,

Thanks for your query.

Firstly, HRCT scan chest report is incomplete.

Further, there is a great variation in the X-ray and CT scan findings.

CT scan- being more sensitive and specific than a conventional X-ray-...

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Dear Doctor, I do not have tuberculosis, but I would like to learn more about it. Could you please answer the following questions for me? (1) Tuberculosis can be caused by an infection but is tuberculosis also an infection? That is, is the infection that causes TB the same thing as TB? Tuberculosis, if not adequately treated, can be fatal. But (2) is there a form of TB that BY ITSELF can directly kill someone, and (3) is there a form of TB that is more likely to lead to some other conditions (examples please) that can directly kill the person?

doctor1 MD

Brief Answer:
Mortality in tuberculosis

Detailed Answer:
Hello,
Thank you for trusting HCM

Tuberculosis is the infection caused by bacteria(Mycobacterium tuberculosis).
Tuberculosis usually affects the lungs but can also spread to other parts of the body.

If not adequately treated Tuberculosis...

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My mother F/69 yrs, 4'11" and 70 kgs who is a patient of Interstital Lung Disease with PAH has developed severe ARDS and is presently on Bipap (present IPAP:EPAP settings 20/10) since 15 days.

However, since last 2 days her PaCO2 levels have gone to 134mm. SpO2 is 88% and PO2 is 66%. She is not able to react much apart from some pain.

She also has developed whole body edema and urine output is reduced with a creatine of 1.06 and a urea level of 111. Respiratory rate is 50.

Today she is on :
1. IV Effcolin (Glaxo) 100mg TDS
2. Azoran 50mg OD
3. Medrol 4mg OD
4. Bosantas 62.5 mg BD - Stopped today due to dropping hct levels
5. Sidenafil 20mg TDS
6. IV Albumin OD (SOS)
7. IV Pantocid 40mg OD
8. IV Actamase 2g BD
9. Lasix(Cipla) 20mg - BP Guided
10. Shecal OD
11. Aminophylline @ 10 microdrops/minute with DNS. Target heart rate = 100
12. K-Bind powder depending on Potassium levels
13. Moodalert BD

Doctor have advised to intubate her with little chance of recovery later.

Please advise ....as we are distressed and in urgent need of medical advise.

I am interested in reducing Blood PaCO2 through ECMO if possible

doctor1 MD

Hi XXXXXXX

Thank you for posting your query.

From the query posted, it appears that your mother is suffering from interstitial lung disease, which is a disease of lung parenchyma affecting the area in the lung where gases exchange take place.

You have not mentioned since how long she is...

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Hi My Kid is now 1.5 yrs. At his birth he was kept in Ventilator because of this he got Pneumothorax. But it was cured fully. Actaully he did not have it by birth only because he was kept in ventilator this happened. My concern is will it occur again in future? What prcaution should i take? Please advice

doctor1 MD

Hello XXXXXXX

Thanks for your query.

As you mentioned that your sons condition developed as a result of being on mechanical ventilation, there is nothing to be worried.

It is common for young babies , with respiratory difficulty to be ventilated with a artificial respirator. But due to the...

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I had a drop of orange juice in my throat and my throat started to close. I cold hardly breathe, every breath sounded terrible, and I felt as if I had no air going in. A terrible feeling. About to cal 911 but it gradually opened up again.
This lasted about 45 seconds or so.

doctor1 MD

Hello and thanks for your query.

I can appreciate that you had a very worrisome experience just now. I am glad to hear you are feeling better however. Sometimes acidic beverages such as orange juice can trigger some inflammation in the back of the throat or upper part of the airway. If a small...

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Recent questions on  Acute respiratory distress syndrome

doctor1 MD

My Father is a 49 year old man that has a dephibulator for 5 years now. This past Sunday he devoloped pnuemonia the doctors gave my father doubtamine to give his heart an extra squeeze that has resulted to kidney failure now today thursday the doctors come to me and say he has ARDS he is already on a ventilator at 60% venus and art blood gas are great they have him sadated fully to prevent fighting the vent but any time they turn him his sats drop what do you think his chances are to survive? The Doctors will not tell me can you please give me a direct answer.

doctor1 MD

I had been in coma for 3 days and was in ventillation for 7 days due to ARDS in the last february but since then after my recovery I started having severe pain in my chest accompanied with breathing problem. Doctor has advice me to go thruogh a chest x-ray, it shows little congestion in lungs. But doctor has told me that it cant be the cause of chest pain. I am an field executive and had to work through the entire day in the field. I used to take alzolam 0.5mg every night because I have severe sleeping disorder and tremendous pressure of work. May I please know how can I get relief of the pain?

doctor1 MD

Good Day My son has been suffering for almost a year now with hyperinflation, shortness of breath when active and low saturation levels if not permanently on oxygen. He has some form of fibrosis of the lungs from previous infections. He has never had a proper diagnosis of what his condition is but it appears that he has some form of pulmonary dysplasia possibly asthma but he has never been well enough to make a proper diagnosis for asthma. He has very sensitive airways and the right middle lobe of his lung is partially collapsed but we have been told that for the amount of lung that has collapsed, his hyperinflation and shortness of breath seems to be far to much. He is on bronchiole dialators, almost always on antibiotics because he seems to catch any infection very easily and is on permanent oxygen. He will be 3 in March. Is there anything that you can recommend I can do, or something you can suggest that maybe the doctors he has been seeing have maybe overseen, please I am desperate to get my son better. Kind Regards, Steve

doctor1 MD

Hi,
I am P Kumar from New Delhi India. I am 63 years old. In my annual health checkup I had X Ray Chest PA/AP view.
Result of investigation says:
Bronchvascular markings in bilateral lung fields;
cardiac size boarderlins;
Bilateral costophrenic angle clear and calcification of arotic knucle.
Would you please explain how is my lung. Is there any serious problem ? What should be the line treatment?
Thanks and regards

doctor1 MD

Extensive inhomogeneous opacification noted at both lung fields, sparing some upper zones indicating bilateral consolidation

doctor1 MD

Hi Doctor , My mother 56 years of age was suffering from fever and breathless XXXXXXX yesterday she was diagnosed with H1N1 .enclosing her test report . doctor has shifter her to RCU. Do you think there was need to shift to RCU and is case...

doctor1 MD

Dear Doctor, I do not have tuberculosis , but I would like to learn more about it. Could you please answer the following questions for me? (1) Tuberculosis can be caused by an infection but is tuberculosis also an infection? That is, is the...