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__NOTOC__
__NOTOC__
{{Acute respiratory distress syndrome}}
{{Acute respiratory distress syndrome}}
{{CMG}}; {{AE}} {{BShaller}}, {{AO}}
{{CMG}}; {{AE}} {{AO}}, {{BShaller}}


==Overview==
==Overview==
ARDS may result from a wide variety of direct and indirect insults to the lung. The most common cause of ARDS is [[sepsis]], followed by [[aspiration pneumonia|aspiration pneumonitis]] and [[transfusion-related acute lung injury|transfusion-related acute lung injury (TRALI)]].<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> Certain medical comorbidities (e.g., [[chronic liver disease|chronic liver]] or [[chronic kidney disease|chronic kidney disease]], [[alcoholism]], [[HIV|infection with the human immunodeficiency virus]], prior [[organ transplantation]]) predispose to the development of ARDS, and the risk for developing ARDS increases along with the number of acute insults sustained by the patient (e.g., [[pneumonia]] and [[pancreatitis]] versus [[pancreatitis]] alone).
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==
===Life Threatening Causes===
===Life Threatening Causes===
ARDS itself is a life-threatening condition that carries a high [[mortality rate]]; as such, any cause of ARDS may be considered life-threatening.
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==
===Common Causes===
ARDS may occur as the result of either a ''direct'' or ''indirect'' insult to the lungs:
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>
*'''Direct insult'''
 
:*[[Pneumonia|Pneumonia (bacterial, viral, fungal, or parasitic]]
* '''Direct insult'''
:*[[Chemical pneumonitis|Aspiration pneumonitis]]
:* [[Pneumonia]] (bacterial, viral, fungal, or parasitic)
:*[[Toxic inhalation]]
:* [[Aspiration pneumonia|Aspiration of of gastric contents]]
:*[[Smoke inhalation]]
:* [[Acute inhalation injury|Inhalational injury]] (e.g., [[smoke inhalation]], toxic gas inhalation)
:*[[Fat embolism]]
:* [[Fat embolism]]
:*[[Amniotic fluid embolism]]
:* [[Amniotic fluid embolism]]
:*[[Drowning|Near-drowning]] (fresh water drowning seems to be more likely to cause ARDS than salt water drowning)
:* [[Drowning|Drowning]]
:*Physical trauma to the lungs (e.g., [[pulmonary contusion]])
:* [[Pulmonary contusion]]
*'''Indirect insult''':  
:* [[Pulmonary hemorrhage|Alveolar hemorrhage]]
:*[[Sepsis]]
:* [[Reperfusion]] ([[Thoracentesis|pleural effusion drainage]], [[embolectomy]])
:*[[TRALI|massive blood transfusion]]
:* [[Lung transplantation]]
:*[[Adverse drug reaction]]s and [[toxic exposures]] (e.g., [[acetylsalicylic acid]] overdose, [[heroin]] overdose)
:* [[Ventilator-associated lung injury]]
:*Extrapulmonary traumatic injury (e.g., [[head trauma]], [[polytrauma]])
* '''Indirect insult''':
:*[[Pancreatitis]]
:* Severe [[sepsis]]
:*[[Burns|Surface burns]]
:* Major [[trauma]] (e.g., [[head trauma]], [[polytrauma]])
:*[[Cardiopulmonary bypass]]
:* 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]]


===Causes by Organ System===
===Causes by Organ System===
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Acetylsalicylic acid]], [[ado-trastuzumab emtansine]], [[afatinib]], [[amiodarone]], [[crizotinib]], [[cytarabine]], [[cytomegalovirus immune globulin]], [[docetaxel]], [[filgrastim]], [[follitropin]], [[gemcitabine]], [[mitomycin]], [[nitrofurantoin]], [[sorafenib]], [[tbo-filgrastim]], [[urofollitropin]]
|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"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[Eosinophilic pneumonia|Acute eosinophilic pneumonia]], [[Smoke inhalation|inhalation injury]], [[drowning|near-drowning]], [[Burn|surface burns]]
|bgcolor="Beige"| [[Eosinophilic pneumonia|Acute eosinophilic pneumonia]], [[Acute inhalation injury|inhalation injury]], [[drowning|near-drowning]], [[Burn|surface burns]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Traumatic brain injury (TBI)]]
|bgcolor="Beige"| [[Traumatic brain injury|Traumatic brain injury (TBI)]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Pulmonary contusion]], [[polytrauma]], [[Physical trauma|severe trauma]], [[traumatic brain injury (TBI)]]
|bgcolor="Beige"| [[Pulmonary contusion]], [[polytrauma]], [[Physical trauma|severe trauma]], [[Traumatic brain injury|traumatic brain injury (TBI)]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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*[[Fat embolism]]
*[[Fat embolism]]
*[[Filgastrim]]
*[[Filgastrim]]
*[[Follitropin]]
*[[Gonadotropin preparations|Follitropin]]
*[[Gemcitabine]]
*[[Gemcitabine]]
*[[Heroin|Heroin overdose]]
*[[Heroin|Heroin overdose]]
Line 201: Line 207:


[[Category:Pulmonology]]
[[Category:Pulmonology]]
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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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