Treatment for Severe Acute Respiratory Distress Syndrome Linked to Covid-19

Treatment for Severe Acute Respiratory Distress Syndrome Linked to Covid-19

Acute respiratory distress syndrome (ARDS) is when the lungs cannot provide sufficient oxygen to the body’s vital organs. It is a life-threatening condition that is currently being seen among patients with serious cases of Covid-19. Symptoms include severe shortness of breath, shallow rapid breathing, confusion, drowsiness or feeling faint.

Causes of ARDS

When the lungs become severely inflamed as the result of an infection like Covid-19 or pneumonia, inflammation can cause fluid from nearby blood vessels to leak into the tiny air sacs inside the lungs. This can make breathing increasingly difficult.

ARDS is a complication of other serious health conditions, which means that most people who develop it are already in hospital. However, this is not always the case so you should always seek urgent medical help if someone develops breathing problems.

Diagnosing ARDS

If ARDS is suspected you are likely to be given a blood test to measure the amount of oxygen in your blood and to test for infection.

A pulse oximetry test can measure how much oxygen is being absorbed by your blood. You may also be given an echocardiogram to check your heart and blood vessels, as well as a chest X-ray or CT scan.

Treating ARDS linked to Covid-19

The current Covid-19 pandemic has led to high numbers of patients with ARDS being admitted to intensive care. Patients with ARDS need a ventilator to help them breathe.

In milder cases you may be given a mask attached to the machine to breathe through. If your breathing is severely affected, a breathing tube will be inserted down your throat and into your lungs. You will be fed and given fluids via a tube that passes through your nose to your stomach. You will also be given medication to treat the underlying cause of ARDS.

The machine used to support your breathing is called an ECMO (or extracorporeal membrane oxygenation) machine. It is, essentially an artificial lung located outside the body. It is designed to put oxygen into your blood and continuously pump this blood into and around your body. It can take over the function of your lungs, allowing them time to rest and heal.

Recovery from ARDS

People who recover from acute respiratory distress syndrome may develop complications such as nerve and muscle damage. Some may also develop psychological problems including depression and PTSD.

However, the lungs generally are able to recover without long-term problems.

Alternatives to ECMO treatment for Covid-19

The NHS has increased the number of hospitals with the capacity to provide ECMO during the pandemic. Nevertheless, demand may exceed available resources and other evidence-based treatments may be offered instead, such as high-flow nasal oxygen for patients which can prevent or delay the need for ECMO.

Other possible treatments include tidal volume, plateau airway pressure, positive end-expiratory pressure and prone positioning (lying the patient on their front).

Understanding more about Covid-19

As Covid-19 is a new disease, doctors are continuing to learn from patients who have been treated and recovered to find out more about its epidemiology, biological mechanisms and the effects of new pharmacological interventions. The Extracorporeal Life Support Organization is an international, non-profit consortium that is planning to create a registry of patients to enable better understanding of how ECMO is being used to treat patients with Covid-19.

As we move into the next phase of the pandemic, it is important to continue to follow government guidelines to prevent the spread of the virus, particularly if you are in one of the high risk categories.

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