Adult acute respiratory distress syndrome

What it is

From: Orphanet

A very severe form of acute pulmonary failure secondary to capillary permeability impairment. The symptoms include dyspnea, hypotension and multivisceral failure. The disease is characterized by bilateral pulmonary infiltrates and severe hypoxemia due to increased alveolar-capillary permeability. The severity depends on the degree of alveolar epithelial injury, with a mortality rate of 30-50%.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Abnormal blood gas level · Very frequent (99-80%)

An abnormality of the partial pressure of oxygen or carbon dioxide in the arterial blood.

Abnormal circulating interleukin concentration · Very frequent (99-80%)

The concentration of an interleukin (a class of cytokines) is outside the limits of normal.

Dyspnea · Very frequent (99-80%)

Difficult or labored breathing. Dyspnea is a subjective feeling only the patient can rate, e.g., on a Borg scale.

Hypoxemia · Very frequent (99-80%)

An abnormally low level of blood oxygen.

Pulmonary infiltrates · Very frequent (99-80%)

Abnormality of tumor necrosis factor secretion · Frequent (79-30%)

An abnormality in the production or cellular release of tumor necrosis factor.

Hypotension · Frequent (79-30%)

Low Blood Pressure, vascular hypotension.

Increased circulating interleukin 6 concentration · Frequent (79-30%)

The concentration of interleukin-6 in the blood circulation is above the upper limit of normal.

Metabolic acidosis · Frequent (79-30%)

Metabolic acidosis (MA) is characterized by a fall in blood pH due to a reduction of serum bicarbonate concentration. This can occur as a result of either the accumulation of acids (high anion gap MA) or the loss of bicarbonate from the gastrointestinal tract or the kidney (hyperchloremic MA). By definition, MA is not due to a respirary cause.

Pulmonary edema · Frequent (79-30%)

Fluid accumulation in the lungs.

Respiratory failure · Frequent (79-30%)

A severe form of respiratory insufficiency characterized by inadequate gas exchange such that the levels of oxygen or carbon dioxide cannot be maintained within normal limits.

Sepsis · Frequent (79-30%)

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.

Shock · Frequent (79-30%)

The state in which profound and widespread reduction of effective tissue perfusion leads first to reversible, and then if prolonged, to irreversible cellular injury.

Pneumonia · Occasional (29-5%)

Inflammation of any part of the lung parenchyma.

Other findings in the same source

From: Orphanet

Additional reported features include Diabetic ketoacidosis (Very rare (<4-1%)); Pancreatitis (Very rare (<4-1%)); Vasculitis (Very rare (<4-1%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

Adult

Inheritance in the source

From: Orphanet

Not applicable

Frequency and the population described

From: Orphanet

Annual incidence: 6-9 / 10 000; United States; Value and class. Annual incidence: 1-9 / 100 000; Spain; Value and class. Annual incidence: 1-9 / 100 000; Finland; Value and class. Annual incidence: 1-5 / 10 000; Sweden; Value and class.

Which doctor should you see?

The suggested department for discussing Adult acute respiratory distress syndrome is Pulmonology, with a pulmonologist / chest physician as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• What is the likely explanation for the breathing symptoms?
• Would a breathing test or another investigation change management?
• If symptoms worsen, what written action plan should be followed?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Adult acute respiratory distress syndrome. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.