Health Dictionary

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

Pneumonia (bacterial, viral, fungal, or parasitic)
Aspiration of of gastric contents
Inhalational injury (e.g., smoke inhalation, toxic gas inhalation)
Fat embolism
Amniotic fluid embolism
Drowning
Pulmonary contusion
Alveolar hemorrhage
Reperfusion (pleural effusion drainage, embolectomy)
Lung transplantation
Ventilator-associated lung injury

Indirect insult:

Severe sepsis
Major trauma (e.g., head trauma, polytrauma)
Multiple transfusions or 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

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

↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.

[pmid7091520-1] 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.

[pmid23989174-6] 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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