Diagnosis
There's no specific test for ARDS. Healthcare professionals base the diagnosis on physical exams, chest X-rays and oxygen levels. It's also important to rule out other diseases and conditions, such as certain heart problems that can lead to similar symptoms.
Imaging
A chest X-ray can show which parts of your lungs, and how much of the lungs, have fluid in them and whether your heart has gotten bigger. Another test called a CT scan combines X-ray images taken from many directions and creates cross-sectional views of internal organs. CT scans can give detailed information about the structures within the heart and lungs.
Lab tests
A test using blood from an artery can measure your oxygen level. Other types of blood tests can check for symptoms of infection or other medical conditions. If your healthcare professional thinks that you have a lung infection, secretions from your airway may be tested to find the cause of the infection.
Heart tests
Because the symptoms of ARDS are like those of certain heart problems, your healthcare professional may recommend heart tests such as:
- Electrocardiogram. This painless test, which also is known as an ECG, tracks the electrical activity in your heart. During the test, a healthcare professional attaches several wired sensors to your body.
- Echocardiogram. This test uses sound waves to create pictures of the heart. It shows how blood moves through the heart chambers and heart valves, and whether there are changes in the structures of your heart.
Treatment
The first goal in treating ARDS is to improve the levels of oxygen in your blood. Without oxygen, your organs can't work properly.
Oxygen
To get more oxygen into your bloodstream, your healthcare professional likely will use:
- Extra oxygen. For milder symptoms or as a short-term treatment, oxygen may be delivered through a mask that fits tightly over your nose and mouth.
- Mechanical ventilation. Most people with ARDS need the help of a machine to breathe. A mechanical ventilator pushes air into your lungs and forces some of the fluid out of the air sacs.
Extracorporeal membrane oxygenation (ECMO)
ECMO may be an option for severe ARDS when other treatment options, such as mechanical ventilation, don't work. ECMO takes over for the heart, lungs or both for a limited time while the lungs rest and heal. This treatment can help when the body can't provide the tissues with enough oxygen.
The ECMO machine is an artificial heart and lung, removing blood from the body through tubes and pumping the blood through the artificial lung. This process removes carbon dioxide and adds oxygen. Then the machine pumps the blood back into the body. Because of the risks involved, it's important to discuss the pros and cons of ECMO with your healthcare team.
Prone positioning
For some people with ARDS, positioning on the stomach — what's known as a prone position — during mechanical ventilation may make more oxygen available to the lungs.
Fluids
Carefully managing the amount of IV fluids given to people with ARDS is very important. Giving too much fluid can make more fluid build up in the lungs. Giving too little fluid can strain the heart and other organs, leading to shock.
Medication
People with ARDS usually get medicine to:
- Prevent and treat infections.
- Ease pain and discomfort.
- Prevent blood clots in the legs and lungs.
- Reduce gastric acid reflux as much as possible.
- Help them feel calm or less anxious.
Lung transplant
When other treatments don't help, lung transplant may be an option for some carefully chosen people who have ARDS. Usually, these are people who were healthy before they developed severe ARDS. Because lung transplant is such a hard process, it should be done at a center that has highly skilled, experienced surgeons and transplant teams.
Lifestyle and home remedies
If you're recovering from ARDS, these suggestions can help protect your lungs:
- Quit smoking. If you smoke, seek help to quit. Also, stay away from secondhand smoke whenever you can.
- Get vaccinated. Getting the flu, also called influenza, shot every year, as well as the pneumonia vaccine as often as recommended, can lower your risk of lung infections.
- Attend pulmonary rehabilitation. Many medical centers now offer pulmonary rehabilitation programs that include exercise training, education and counseling to help you learn how to get back to your usual activities and get to your ideal weight.
Coping and support
Recovery from ARDS can take time, and you're likely to need plenty of support. Although everyone's recovery is different, being aware of common challenges that others with the condition have had can help.
Consider these tips:
- Ask for help. Be sure you have help with everyday tasks until you know what you can manage on your own. This is particularly important when you come home from the hospital.
- Join a support group. There are support groups for people with lifelong lung problems. Discover what's available in your community or online and consider joining others with similar experiences.
- Seek professional help. If you have symptoms of depression, such as hopelessness and loss of interest in your usual activities, tell your healthcare professional or contact a mental health professional. Depression is common in people who have had ARDS, and treatment can help.