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{{Acute respiratory distress syndrome}}
{{Acute respiratory distress syndrome}}
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==Overview==
==Overview==
ARDS may be caused by either direct or indirect insults to the lung. Common causes of ARDS include [[pneumonia]], [[sepsis]], [[aspiration pneumonia|aspiration of gastric contents]], and [[transfusion-related acute lung injury|transfusion-related acute lung injury (TRALI)]].


==Causes==
==Causes==
ARDS can be caused by any major swelling (inflammation) or injury to the lung. Some common causes include:
===Life Threatening Causes===
ARDS is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.
 
===Common Causes===
ARDS may occur as the result of either a direct or indirect insult to the lungs:<ref name="pmid7091520">{{cite journal| author=Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ| title=Clinical predictors of the adult respiratory distress syndrome. | journal=Am J Surg | year= 1982 | volume= 144 | issue= 1 | pages= 124-30 | pmid=7091520 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7091520  }} </ref><ref>The ARDS Definition Task Force*. “Acute Respiratory Distress Syndrome: The Berlin Definition.” JAMA 307, no. 23 (June 20, 2012): 2526–33. doi:10.1001/jama.2012.5669.</ref><ref>Wheeler, Arthur P., and Gordon R. Bernard. “Acute Lung Injury and the Acute Respiratory Distress Syndrome: A Clinical Review.” Lancet (London, England) 369, no. 9572 (May 5, 2007): 1553–64. doi:10.1016/S0140-6736(07)60604-7.</ref><ref>Sweeney, Rob Mac, and Daniel F. McAuley. “Acute Respiratory Distress Syndrome.” Lancet (London, England), April 28, 2016. doi:10.1016/S0140-6736(16)00578-X.</ref><ref>Fowler, A. A., R. F. Hamman, J. T. Good, K. N. Benson, M. Baird, D. J. Eberle, T. L. Petty, and T. M. Hyers. “Adult Respiratory Distress Syndrome: Risk with Common Predispositions.” Annals of Internal Medicine 98, no. 5 Pt 1 (May 1983): 593–97.</ref>


* Breathing vomit into the lungs (aspiration)
* '''Direct insult'''
* Inhaling chemicals
:* [[Pneumonia]] (bacterial, viral, fungal, or parasitic)
* Pneumonia
:* [[Aspiration pneumonia|Aspiration of of gastric contents]]
* Septic shock
:* [[Acute inhalation injury|Inhalational injury]] (e.g., [[smoke inhalation]], toxic gas inhalation)
* Trauma
:* [[Fat embolism]]
:* [[Amniotic fluid embolism]]
:* [[Drowning|Drowning]]
:* [[Pulmonary contusion]]
:* [[Pulmonary hemorrhage|Alveolar hemorrhage]]
:* [[Reperfusion]] ([[Thoracentesis|pleural effusion drainage]], [[embolectomy]])
:* [[Lung transplantation]]
:* [[Ventilator-associated lung injury]]
* '''Indirect insult''':
:* Severe [[sepsis]]
:* Major [[trauma]] (e.g., [[head trauma]], [[polytrauma]])
:* Multiple [[transfusion]]s or [[TRALI|transfusion-associated acute lung injury (TRALI)]]
:* [[Drug overdose]] (e.g., [[acetylsalicylic acid]] overdose, [[heroin]] overdose)
:* [[Pancreatitis]]
:* Severe [[burns]]
:* [[Shock]]
:* [[Cardiopulmonary bypass]]
:* [[Disseminated intravascular coagulation]]


ARDS leads to a buildup of fluid in the air sacs. This fluid prevents enough oxygen from passing into the bloodstream.
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Mercury poisoning|Mercury inhalation]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Stevens-Johnson syndrome]], [[toxic epidermal necrolysis]]<ref name="pmid23989174">{{cite journal| author=de Prost N, Mekontso-Dessap A, Valeyrie-Allanore L, Van Nhieu JT, Duong TA, Chosidow O et al.| title=Acute respiratory failure in patients with toxic epidermal necrolysis: clinical features and factors associated with mechanical ventilation. | journal=Crit Care Med | year= 2014 | volume= 42 | issue= 1 | pages= 118-28 | pmid=23989174 | doi=10.1097/CCM.0b013e31829eb94f | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23989174  }} </ref>
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Acetylsalicylic acid]], [[ado-trastuzumab emtansine]], [[afatinib]], [[amiodarone]], [[crizotinib]], [[cytarabine]], [[cytomegalovirus immune globulin]], [[docetaxel]], [[filgrastim]], [[Gonadotropin preparations|follitropin]], [[gemcitabine]], [[mitomycin]], [[nitrofurantoin]], [[sorafenib]], [[tbo-filgrastim]], [[urofollitropin]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Eosinophilic pneumonia|Acute eosinophilic pneumonia]], [[Acute inhalation injury|inhalation injury]], [[drowning|near-drowning]], [[Burn|surface burns]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Aspiration pneumonia|Aspiration of gastric contents]], [[pancreatitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Bone marrow transplantation]], [[transfusion-related acute lung injury|massive blood transfusion]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Bone marrow transplantation]], [[cardiopulmonary bypass]], [[transfusion-related acute lung injury|massive blood transfusion]], [[oxygen toxicity]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Eosinophilic pneumonia|Acute eosinophilic pneumonia]], [[ehrlichiosis]], [[leptospirosis]], [[malaria]], [[miliary tuberculosis]], [[pneumonia|pneumonia (bacterial, viral, fungal, or parasitic)]], [[sepsis]], [[severe acute respiratory syndrome|severe acute respiratory syndrome (SARS)]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Fat embolism]], [[polytrauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Traumatic brain injury|Traumatic brain injury (TBI)]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Amniotic fluid embolism]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Acetylsalicylic acid]], [[heroin]], [[naloxone]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"|  [[Eosinophilic pneumonia|Acute eosinophilic pneumonia]], [[Chemical pneumonitis|aspiration of gastric contents]], [[cryptogenic organizing pneumonia|Cryptogenic organizing pneumonia (COP)]], [[decompression sickness]], [[fat embolism]], [[lung transplantation]], [[pneumonia]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Uremia]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Anaphylaxis]], [[bone marrow transplantation]], [[Agglutination#Leukoagglutination|leukoagglutin reactions]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Pulmonary contusion]], [[polytrauma]], [[Physical trauma|severe trauma]], [[Traumatic brain injury|traumatic brain injury (TBI)]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


The fluid buildup also makes the lungs heavy and stiff, and decreases the lungs' ability to expand. The level of oxygen in the blood can stay dangerously low, even if the person receives oxygen from a breathing machine (mechanical ventilator) through a breathing tube (endotracheal tube).
===Causes in Alphabetical Order===
ARDS often occurs along with the failure of other organ systems, such as the liver or the kidneys. Cigarette smoking and heavy alcohol use may be risk factors.
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Acetylsalicylic acid]]
*[[Ado-trastuzumab emtansine]]
*[[Eosinophilic pneumonia|Acute eosinophilic pneumonia]]
*[[Afatinib]]
*[[Amiodarone]]
*[[Amniotic fluid embolism]]
*[[Anaphylaxis]]
*[[Chemical pneumonitis|Aspiration of gastric contents]]
*[[Bone marrow transplantation]]
*[[Cardiopulmonary bypass]]
*[[Crizotinib]]
*[[Cryptogenic organizing pneumonia|Cryptogenic organizing pneumonia (COP)]]
*[[Cytarabine]]
*[[Cytomegalovirus immune globulin]]
*[[Docetaxel]]
*[[Ehrlichiosis]]
*[[Fat embolism]]
*[[Filgastrim]]
*[[Gonadotropin preparations|Follitropin]]
*[[Gemcitabine]]
*[[Heroin|Heroin overdose]]
*[[Smoke inhalation|Inhalation injury]]
*[[Leptospirosis]]
*[[Agglutination#Leukoagglutination|Leukoagglutin reactions]]
{{col-break|width=33%}}
*[[Malaria]]
*[[Miliary tuberculosis]]
*[[Mitomycin]]
*[[Transfusion-related acute lung injury|Massive blood transfusion]]
*[[Naloxone|Naloxone overdose]]
*[[Drowning|Near-drowning]]
*[[Nitrofurantoin]]
*[[Oxygen toxicity]]
*[[Pancreatitis]]
*[[Pneumonia]]
*[[Polytrauma]]
*[[Pulmonary contusion]]
*[[Sepsis]]
*[[Severe acute respiratory syndrome|Severe acute respiratory syndrome (SARS)]]
*[[Sorafenib]]
*[[Physical trauma|Severe trauma]]
*[[Stevens-Johnson syndrome]]
*[[Burn|Surface burns]]
*[[Tbo-filgrastim]]
*[[Toxic epidermal necrolysis]]
*[[Traumatic brain injury|Traumatic brain injury (TBI)]]
*[[Uremia]]
*[[Urofollitropin]]
{{col-end}}


==References==
==References==
{{reflist|2}}


{{Reflist|2}}
[[Category:Pulmonology]]
[[Category:Needs content]]

Latest revision as of 17:02, 14 July 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2], Brian Shaller, M.D. [3]

Overview

ARDS may be caused by either direct or indirect insults to the lung. Common causes of ARDS include pneumonia, sepsis, aspiration of gastric contents, and transfusion-related acute lung injury (TRALI).

Causes

Life Threatening Causes

ARDS is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.

Common Causes

ARDS may occur as the result of either a direct or indirect insult to the lungs:[1][2][3][4][5]

  • Direct insult
  • Indirect insult:

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning Mercury inhalation
Dental No underlying causes
Dermatologic Stevens-Johnson syndrome, toxic epidermal necrolysis[6]
Drug Side Effect Acetylsalicylic acid, ado-trastuzumab emtansine, afatinib, amiodarone, crizotinib, cytarabine, cytomegalovirus immune globulin, docetaxel, filgrastim, follitropin, gemcitabine, mitomycin, nitrofurantoin, sorafenib, tbo-filgrastim, urofollitropin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental Acute eosinophilic pneumonia, inhalation injury, near-drowning, surface burns
Gastroenterologic Aspiration of gastric contents, pancreatitis
Genetic No underlying causes
Hematologic Bone marrow transplantation, massive blood transfusion
Iatrogenic Bone marrow transplantation, cardiopulmonary bypass, massive blood transfusion, oxygen toxicity
Infectious Disease Acute eosinophilic pneumonia, ehrlichiosis, leptospirosis, malaria, miliary tuberculosis, pneumonia (bacterial, viral, fungal, or parasitic), sepsis, severe acute respiratory syndrome (SARS)
Musculoskeletal/Orthopedic Fat embolism, polytrauma
Neurologic Traumatic brain injury (TBI)
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Amniotic fluid embolism
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity Acetylsalicylic acid, heroin, naloxone
Psychiatric No underlying causes
Pulmonary Acute eosinophilic pneumonia, aspiration of gastric contents, Cryptogenic organizing pneumonia (COP), decompression sickness, fat embolism, lung transplantation, pneumonia
Renal/Electrolyte Uremia
Rheumatology/Immunology/Allergy Anaphylaxis, bone marrow transplantation, leukoagglutin reactions
Sexual No underlying causes
Trauma Pulmonary contusion, polytrauma, severe trauma, traumatic brain injury (TBI)
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ (1982). "Clinical predictors of the adult respiratory distress syndrome". Am J Surg. 144 (1): 124–30. PMID 7091520.
  2. ↑ The ARDS Definition Task Force*. “Acute Respiratory Distress Syndrome: The Berlin Definition.” JAMA 307, no. 23 (June 20, 2012): 2526–33. doi:10.1001/jama.2012.5669.
  3. ↑ Wheeler, Arthur P., and Gordon R. Bernard. “Acute Lung Injury and the Acute Respiratory Distress Syndrome: A Clinical Review.” Lancet (London, England) 369, no. 9572 (May 5, 2007): 1553–64. doi:10.1016/S0140-6736(07)60604-7.
  4. ↑ Sweeney, Rob Mac, and Daniel F. McAuley. “Acute Respiratory Distress Syndrome.” Lancet (London, England), April 28, 2016. doi:10.1016/S0140-6736(16)00578-X.
  5. ↑ Fowler, A. A., R. F. Hamman, J. T. Good, K. N. Benson, M. Baird, D. J. Eberle, T. L. Petty, and T. M. Hyers. “Adult Respiratory Distress Syndrome: Risk with Common Predispositions.” Annals of Internal Medicine 98, no. 5 Pt 1 (May 1983): 593–97.
  6. ↑ de Prost N, Mekontso-Dessap A, Valeyrie-Allanore L, Van Nhieu JT, Duong TA, Chosidow O; et al. (2014). "Acute respiratory failure in patients with toxic epidermal necrolysis: clinical features and factors associated with mechanical ventilation". Crit Care Med. 42 (1): 118–28. doi:10.1097/CCM.0b013e31829eb94f. PMID 23989174.
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