ARDS means acute respiratory distress syndrome. It is a respiratory disorder. Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps the lungs from filling with enough air, which means less oxygen reaches to the bloodstream. This deprives body organs of the oxygen they need to function.

2. INTRODUCTION
 Acute respiratory distress syndrome (ARDS) is a
severe lung condition.
 It occurs when fluid fills up the air sacs in the lungs.

3. DEFINITION
 Acute respiratory distress syndrome, or ARDS, is an
inflammatory lung injury that happens when fluids build up in
small air sacs (called alveoli) in the lungs.
 ARDS prevents the lungs from filling up with air and causes
dangerously low oxygen levels in the blood (hypoxemia).
 This condition prevents other organs such as brain, heart,
kidneys and stomach from getting the oxygen they need to
function.

4. INTRODUCTION
 Acute respiratory distress syndrome (ARDS) occurs when
fluid builds up in the tiny, elastic air sacs (alveoli) in the
lungs.
 The fluid keeps lungs from filling with enough air, which
means less oxygen reaches to bloodstream.
 This deprives organs from oxygen they need to function.

5. DEFINITION
 Acute respiratory distress syndrome (ARDS is
a sudden and progressive form of acute
respiratory failure in which the alveolar
capillary membrane becomes damaged and
more permeable to intravascular fluid
resulting in severe dyspnea, hypoxemia and
diffuse pulmonary infiltrate.

6. CAUSES
• Inhaling toxic substances, such as salt water, chemicals, smoke,and vomit
• Developing a severe blood infection
• Developing a severe infection of the lungs, such as pneumonia
• Receiving an injuryto the chest or head, suchas during a car wreck or contact sports
• Overdosing on sedativesor tricyclic antidepressants

7. Risk factors
 ARDS is usually a complication of another condition.
• age over 65 years
• chronic lung disease
• a history of alcohol misuse or cigarette smoking
 ARDS can be a more serious condition for people who:
• have toxic shock
• are older
• have liver failure
• have a history of alcohol misuse

9. STAGE 1
 Injury reduces normal blood to the lungs
 Platelets aggregates and release histamine
(H),serotonin (S) and bradykinin(B).

10. STAGE 2
 Those substances, especially histamine ,inflame and
damage the alveolar –capillary membrane, increasing
capillary permeability .
 Fluids the shift into interstitial space.

11. STAGE 3
 As capillary permeability increases, proteins and fluids
leak out, increasing interstitial osmotic pressure and
causing pulmonary edema.

12. STAGE 4
 Decreased blood flow and fluids in the alveoli damage
surfactant and impair the cells ability to produce more.
 As a result, alveoli collapse, impeding gas exchange and
decreasing lung compliance.

13. STAGE 5
 Sufficient oxygen cannot cross the alveolar –capillary
membrane, but carbon dioxide (CO2) can and is lost
with every exhalation .
 Oxygen (O2) and co2 levels decreases in the blood.

14. STAGE 6
 Pulmonary edema worsens, inflammation leads to
fibrosis and gas exchange is further impeded.

15. PATHOPHYSIOLOGY

16. CLINICAL MANIFESTATIONS
 The symptoms of ARDS typically appear within one week of an injury or
trauma.
• Labored and rapid breathing
• Muscle fatigue and general weakness
• Low blood pressure
• Discolored skin or nails
• A dry, hacking cough
• A fever
• Headaches
• A fast pulse rate
• Mental confusion

17. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• A blood test
• A chest x-ray
• A CT scan
• Throat and nose swabs
• An electrocardiogram
• An echocardiogram
• An airway examination

18. DIAGNOSIS
 Electrocardiogram. This painless test tracks the electrical activity in the heart. It
involves attaching several wired sensors to body.
 Echocardiogram. A sonogram of the heart, this test can reveal problems with the
structures and the function of the heart.

19. MANAGEMENT
 Antibiotics
 Anti inflammatory drugs, corticosteroids
 Diuretics
 Drugs to raise blood pressure
 Anti-anxiety drugs
 Muscle relaxant
 Bronchodilators - midazolam and lorazepam
 Analgesics -Non-opioid analgesics, such as acetaminophen and
nonsteroidal anti-inflammatory drugs (NSAIDs),
 Opioid analgesics, such as morphine, fentanyl, and hydromorphone

20. MANAGEMENT
 Fluids- Carefully managing the amount of intravenous fluids is crucial.
 Too much fluid can increase fluid buildup in the lungs.
 Too little fluid can put a strain on your heart and other organs and lead to shock.
 Supplemental oxygen.
 Supplemental oxygen is given to maintain adequate oxygen saturation levels and
prevent hypoxemia.
 In severe cases, mechanical ventilation may be required to provide adequate
oxygenation.
 Mechanical ventilation. Most people with ARDS will need the help of a machine to
breathe.
 A mechanical ventilator pushes air into lungs and forces some of the fluid out of the
air sacs.
 Quit smoking
 Get immunized

21. Positioning startergies
 Proper positioning.
 Proper positioning can help improve oxygenation, reduce the risk of
complications, and promote lung healing in ARDS patients.
 prone positioning, which involves positioning the patient on their
stomach to improve oxygenation.
 Prone positioning has been shown to improve oxygenation by
redistributing ventilation and perfusion to more functional lung
regions, reducing alveolar collapse, and improving gas exchange.
 Other positioning strategies that may be used in ARDS include sitting
upright, lateral positioning, and Trendelenburg positioning

22. COMPLICATIONS
• Multiple organ failure
• Pulmonary hypertension (increase in blood
pressure)
• Blood clots forming during treatment
• Atelectasis (collapse of the lung’s small air
pockets)

23. NURSING ASSESSMENT
1. Nutritional status: Assess the patient’s nutritional intake and monitor
for signs of malnutrition or weight loss. Work with the dietitian to
develop an appropriate nutrition plan.
2. Skin integrity: Assess for pressure ulcers, especially in patients who are
immobilized or require prolonged mechanical ventilation.
3. Psychosocial status: Assess the patient’s emotional and psychological
well-being. Provide support and education to the patient and family
regarding the diagnosis and treatment of

24. NURSING ASSESSMENT
1. Respiratory status: This includes monitoring respiratory rate, oxygen
saturation, and respiratory effort. Assess for signs of respiratory distress
such as use of accessory muscles, flaring nostrils, and increased work of
breathing.
2. Cardiovascular status: Monitor heart rate, blood pressure, and cardiac
rhythm. Assess for signs of fluid overload, such as peripheral oedema,
lung crackles, and increased jugular venous distension.
3. Neurological status: Assess the level of consciousness, orientation,
and cognitive function. Monitor for signs of delirium or agitation, which
may be caused by hypoxemia or medications.
4. Fluid balance: Monitor intake and output, and assess for signs of fluid
overload or dehydration. Assess skin turgor and mucous membrane
moisture.