FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

ARDS - A LITTLE KNOWN, BUT SERIOUS, BREATHING DISORDER

Question: I got out of the hospital five months ago after having adult respiratory distress syndrome (ARDS). Even though this terrible illness strikes 150,000 people every year, most people have never heard of it. Even my family doctor didn't know much about it. Please let your readers know about ARDS.

Answer: Adult Respiratory Distress Syndrome, also called Acute Respiratory Distress Syndrome or ARDS, is a severe breathing disorder. It strikes between 100,000 and 150,000 people in the United States each year, so it is uncommon but it certainly is not a rare disorder.

Any time you encounter the word "syndrome", you should think of a grouping of symptoms rather than an individual disease. ARDS is a good example. The label is applied to those with a specific group of abnormal X-ray, EKG and blood test results that basically mean the lungs are not able to supply sufficient oxygen for the body. The oxygen deficit then produces symptoms we can all recognize -- shortness of breath, a fast breathing rate and a fast heart rate.

ARDS can result from a number of causes. Common examples are a blood-borne infection called septicemia, inhalation of toxic substances, a complication of pneumonia, near drowning, or from inhaling vomit, alcohol, or other substances that don't belong in the lungs. Trauma to the lung, such as might occur in an auto accident, or complications of a broken leg can also cause ARDS.

ARDS is a very serious illness. The initial symptom is a mild shortness of breath that can progress to a near fatal condition in minutes -- or it may take hours. About 50 percent of those who have it die from the condition, but the death rate can range from 15 to 90 percent, depending largely upon the underlying cause, age of the victim and whether or not organs other than the lungs begin to fail. Obviously, survival is also influenced by how quickly the person gets to an intensive/critical care unit.

One of the essential components of treatment for those with ARDS is the use of a ventilator -- a mechanical device that takes over the work of breathing. In addition, a prompt and aggressive search for the underlying cause must be undertaken. Assuming that the underlying cause is identified and corrected, the person will need to stay on the ventilator for one to three weeks. This is a very stressful time for the patient, his or her loved ones and also for the physicians because of the large number of things that can still go wrong.

Obviously, you are one of the survivors of ARDS. That's good news. An additional bright point is that most who survive ARDS eventually make a complete recovery.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.