Adult Respiratory Distress Syndrome

Adult respiratory distress syndrome (ARDS; Engl. Adult (Acute) Respiratory Distress Syndrome) – colloquially called shock lung – (Adult (Acute) Respiratory Distress Syndrome; synonyms; Adult respiratory distress syndrome [ARDS]; ARDS [adult respiratory distress syndrome]; Respiratory distress syndrome; Adult respiratory distress syndrome [ARDS]; Respiratory distress syndrome; Hyaline membranes in adults; Pulmonary insufficiency after shock; Pulmonary insufficiency after trauma; Respiratory-distress syndrome in adults; ICD-10-GM J80) describes acute respiratory failure in previously lung-healthy individuals.

Leading features of ARDS are severe hypoxia (oxygen deprivation) and pulmonary bilateral infiltrates (bilateral immigration of inflammatory cells into lung tissue).

ARDS is defined according to the Berlin definition (European Society of Intensive Care Medicine, American Thoracic Society, Society of Critical Care Medicine) (see classification below).

Data on incidence (frequency of new cases) vary between 5-50 cases per 100,000 inhabitants per year (in Germany). Taking into account the severity of the disease, the incidence of severe ARDS is about 1.5 cases per 100,000 inhabitants per year and the incidence of mild ARDS is about 89 cases per 100,000 inhabitants per year.

Course and prognosis: The prognosis depends on the success of therapy with regard to the underlying disease and on the time of initiation of therapy for ARDS (the earlier, the better). Regular alcohol consumption and pre-existing extrapulmonary diseases worsen the prognosis.Recognized therapeutic strategy is lung-protective (“lung-protecting”) ventilation as far as possible.

The lethality (mortality relative to the total number of people with the disease) is approximately 10% for posttraumatic ARDS without chest trauma, approximately 25% for posttraumatic ARDS with chest trauma, approximately 50% for parapneumonic ARDS, and more than 80% for ARDS with sepsis (sepsis of the blood) and multiorgandysis.