Acute Respiratory Distress Syndrome - Treatment - Treatment

Oxygen therapy to raise the oxygen levels in your blood is the main treatment for ARDS. Oxygen can be given through tubes resting in your nose, a face mask, or a tube placed in your windpipe.

Depending on the severity of your ARDS, your doctor may suggest a device or machine to support your breathing. These include:

• Non-invasive ventilation, such as bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP) devices. These electronic breathing devices help keep your airways open by blowing air through a face mask.
• A ventilator. Your doctor will adjust the ventilator settings to help prevent any more damage to your lung tissue. If the ventilator helps restore your blood oxygen levels and it is easier to breathe on your own, your doctor may turn off the ventilator to see if you are ready for it to be removed completely. Some people transition from a ventilator to portable oxygen therapy. Risks from being on a ventilator include pneumonia and pneumothorax, which can cause your lungs to collapse.

Your doctor may recommend medicine to relieve symptoms, treat the underlying cause, or prevent complications from being in a hospital. These may include:

• Acid-reducing medicines to prevent stress ulcers, which can cause bleeding in the intestines.
• Antibiotics to treat or prevent infections. If you are on a ventilator, your healthcare team may do tests, such as lung fluid lab tests or CT scans, to look for signs of new infection.
• Blood thinners to stop blood clots from forming or growing larger. Heparin is a common blood thinner for adults.
• Muscle relaxants to help prevent coughing or gagging while on a ventilator or to reduce the amount of oxygen your body needs.
• Pain medicines, which your doctor may prescribe, depending on your needs.
• Sedatives to help relieve anxiety, make it easier to breathe on a ventilator, or lower your body’s oxygen needs. Sometimes your doctor may pair a sedative with another medicine to make it easier to deliver the oxygen. Complications vary depending on the sedative used, the dose, and how long it is used. They can include depression, post-traumatic stress disorder (PTSD), problems with thinking or memory, or a delay in removing the ventilator.

Your doctor may recommend other treatments, including:

• Blood transfusion to treat low hemoglobin levels. Hemoglobin carries oxygen in the blood, so a transfusion can improve the delivery of oxygen to the body’s organs.
• Extracorporeal membrane oxygenation (ECMO) or a similar device, especially for severe ARDS. ECMO helps when ventilation alone cannot deliver enough oxygen or while a patient waits for a lung transplant. ECMO works like an artificial lung, removing carbon dioxide and pumping oxygen-rich blood back into the body.
• Fluid management. Your healthcare team will monitor the fluid balance in your body. Low blood pressure can occur when the fluid in your blood vessels is low. This may prevent oxygen from getting to your organs. To help restore the balance, your doctor may give you fluid through an intravenous (IV) line. When you have too much fluid in the lungs, your doctor may give you medicines that help your body get rid of it.
• Nutritional support. You may need a feeding tube to make sure you get enough of the right nutrients while you are on a ventilator.
• Physical therapy to maintain muscle strength and prevent sores from forming. Movement may help shorten the time you are on a ventilator and improve recovery after you leave the hospital.
• Positioning your body. For severe ARDS, your doctor may recommend that you spend most of the time lying facedown, which helps oxygen get to more of your lungs.

• Research for Your Health will discuss how we are using current research and advancing research to treat people who have ARDS.
• Participate in NHLBI Clinical Trials will explain our open and enrolling clinical studies that are investigating treatments for ARDS.
• Living With will discuss what your doctor may recommend, including lifelong lifestyle changes and medical care to prevent your condition from recurring, getting worse, or causing complications.