Diagnosis and Treatment of ARDS
Diagnosis
ARDS is diagnosed through a combination of clinical observation and tests:
- Arterial blood gases – show very low oxygen levels
- Chest X-ray or CT scan – shows fluid in lungs
- Blood tests – to check infection, inflammation, and organ function
- Echocardiogram – to rule out heart-related causes
ARDS is defined by the Berlin Criteria, which includes:
- Acute onset within 1 week of insult
- Bilateral lung opacities on imaging
- Respiratory failure not explained by heart failure
- Low oxygen levels (PaO2/FiO2 ratio)
Treatment
There is no specific cure for ARDS. Treatment focuses on supportive care while the lungs heal.
1. Mechanical Ventilation
- Most patients need a ventilator in ICU
- Low tidal volume strategy helps prevent further lung injury
2. Oxygen Therapy
- High-flow oxygen or non-invasive ventilation for milder cases
3. Treating Underlying Cause
- Antibiotics for sepsis or pneumonia
- Steroids in select cases (e.g. COVID-19 ARDS)
- Fluids for shock, or diuretics if overloaded
4. Other Support
- Prone positioning (lying on stomach)
- Sedation and neuromuscular blockers
- ECMO (in advanced centres)
Diagnosis and Treatment of ARDS
In South Africa, only major public or private hospitals offer full ICU support. Rapid referral from district to tertiary care is vital.
🔹 Next → [Complications and Recovery from ARDS]
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