ARDS Diagnosis

If you suspect you may have ARDS (or if you experience breathing problems), you should see your provider to get the proper diagnosis¹².

There is no one test used to identify ARDS in particular. Your provider may make a diagnosis based on your medical history, physical exam, chest radiography, and lab studies. Electrocardiography and/or microbiologic studies may also be used.

To look for signs of ARDS, your provider might do one or more of the following:

• Listen for abnormal breathing sounds using a tool called a stethoscope
• Listen for an abnormally fast heart rate
• Check for breathing difficulties
• Look for a bluish tone in your skin or lips (cyanosis), which can indicate low blood oxygen levels
• Check your body for swelling or other signs of extra fluid, which may be linked to heart or kidney problems
• Measure your blood pressure and oxygen levels

Your provider may use imaging tests to look inside your body to look for signs of ARDS. The type of imaging exam your provider uses depends on your symptoms and the part of your body being examined. Imaging tests include:

• Chest X-ray: A chest X-ray can reveal too much fluid in your lungs.
• Computerized tomography (CT): CT scans of the chest or abdomen can check for abdominal infections.

Your provider may use other tests¹³ to measure your blood oxygen levels and heart function. This may allow your provider to detect the condition that’s causing your symptoms, even if it’s not ARDS in particular. These tests may include:

• Blood tests: ARDS may cause your blood to have a low oxygen concentration. Your provider may also check your blood for signs of infection or a heart problem.
• Sputum culture: Your provider may test your airway secretions for signs of infection.
• Bronchoscopy: A bronchoscopy works by inserting a thin tube containing a light and camera through your airway. This test can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs.
• Electrocardiogram: This test involves using several wired sensors attached to your body to track your heart’s electrical activity.
• Echocardiogram: In this test, an ultrasound is used to measure your heart’s functioning. This test can help rule out heart failure, congenital heart defects, or other breathing problems as the cause of your symptoms.

ARDS prognosis

ARDS’ mortality rate¹⁴ ranges from 30–50%, depending on the study consulted. ARDS is usually accompanied by multiple organ system failures, contributing to the condition’s high mortality rate.

There’s a chance that you might develop complications from ARDS. The most common problems are:

• Lung collapse: Lung collapse is a condition in which the lung or part of the lung collapses, causing chest pain and difficulty breathing.

One or more sections of the lung can collapse because of a blockage or pressure outside the bronchial tubes, causing trapped air (atelectasis).

Lung collapse can also occur as a result of a buildup of air in the space between the lung and chest wall (pneumothorax).

Most cases of ARDS are treated through a breathing machine called a ventilator, which increases the concentration of oxygen in the blood and forces fluid out of the lungs. However, the ventilator’s pressure and air volume can potentially force too much gas into the lungs, causing lung collapse.

• Blood clots: Lying still in the hospital for long periods of time increases your risk of getting blood clots in your legs. A portion of the blood clot can break off and travel to your lungs, blocking blood flow (called pulmonary embolism).
• Infections: The use of a ventilator can introduce pathogens (disease-causing germs) to your lungs, which can cause infection.
• Scarring (pulmonary fibrosis): The tissue between the lungs’ air sacs can scar and thicken within a few weeks of the onset of ARDS, making it even harder for oxygen to pass from the air sacs into your bloodstream.
• Increase in blood pressure (pulmonary hypertension): Inflammation or mechanical ventilation can cause the blood vessels to narrow, increasing blood pressure.

ARDS complications

The development of improved treatments for ARDS has increased the condition’s survival rate. However, survivors of ARDS can end up with lasting effects from the condition. Some complications that may result from ARDS include:

• Breathing problems: People who recover most of their lung function may still have lifelong breathing problems that require supplemental oxygen at home.
• Memory and thinking problems: Long periods of being on sedatives and having low blood oxygen can lead to memory loss and cognitive difficulties.
• Tiredness and muscle weakness: Not moving freely for long periods of time in the hospital or on a ventilator can weaken your muscles, making you feel tired after treatment.
• Depression: Most ARDS survivors report going through a period of depression.