Related articles: Respiratory Distress
Definition
Respiratory distress syndrome is a medical emergency that can be caused by various acute diseases that can damage the lungs. This form of acute respiratory failure is characterized by non-cardiogenic pulmonary edema, dyspnea and severe hypoxemia refractory to oxygen therapy.
Respiratory distress is often the consequence of direct alveolar damage, induced by pneumonia, embolism and pulmonary fibrosis, aspiration of gastric contents, semi-drowning, inhalation of toxic fumes or gases, burns and direct thoracic trauma.
Indirect causes, on the other hand, include severe sepsis, multiple blood transfusions, inflammation of the pancreas (pancreatitis), blood clotting disorders, drug overdose and intake of certain drugs (including colchicine and salicylates).
Respiratory distress syndrome can occur in adults and children.
Most common symptoms and signs *
- Anorexia
- Apnea
- Arrhythmia
- Asthenia
- Cyanosis
- Dyspnoea
- Distension of the neck veins
- Chest pain
- Edema
- Hypercapnia
- Hypoxia
- Hypotension
- oliguria
- orthopnea
- Pallor
- Weight loss
- rales
- Wheezing breath
- Reduction of respiratory noise
- Water retention
- Sense of suffocation
- Drowsiness
- Confusional state
- Squeal
- Sweating
- Fainting
- Tachycardia
- tachypnoea
Further indications
Respiratory distress syndrome usually occurs within 24-48 hours of the pathological event or the initial illness, with dyspnea accompanied by rapid and superficial breathing. The severity of the clinical picture depends on the extent of alveolar epithelial lesions. Auscultation can show crackles, buzzes or hisses.
In addition, in the presence of respiratory distress syndrome, cyanosis (bluish coloration of the skin and mucous membranes), vigorous use of accessory respiratory muscles at rest, tachycardia and profuse sweating may be found. Symptoms also include arterial hypotension and multiple organ failure. Therefore, respiratory distress syndrome is a potentially fatal disease.
Diagnosis is generally suspected of wheezing in clinical situations that predispose to respiratory distress syndrome. The evaluation includes an arterial blood gas analysis (which shows an acute respiratory alkalosis) and a chest radiograph (it allows to observe diffuse bilateral alveolar infiltrates). After immediate treatment of hypoxemia, further diagnostic tests are indicated.
Treatment varies depending on the pathology from which respiratory distress syndrome originated, but often includes artificial ventilation.
