Description
A 40-year-old male recently completed a cruise vacation. He presents with severe bilateral pneumonia. He was placed on mechanical ventilation after a positive H1N1 diagnosis.
Acute Respiratory Distress Syndrome (ARDS) is a severe life-threatening condition that is primarily caused by inflammation in the lungs. It’s caused by the sudden onset of widespread inflammation in the lung tissue, leading to impaired gas exchange and severe respiratory distress. It typically starts with an initial injury to the lung tissue and then the body’s immune system triggers an acute inflammatory response in an attempt to repair the damaged lung tissue. The inflammatory response becomes dysregulated which causes extensive damage to the endothelial cells lining the blood vessels within the lungs and the alveolar epithelium which are critical for oxygen exchange. This damage causes increased vascular permeability allowing fluid proteins and immune cells to leak into the alveoli, impairing the lungs’ ability to oxygenate the blood and leading to severe hypoxemia and respiratory failure (Rurua et al., 2023).
Both ARDS and pulmonary hypertension affect the respiratory and circulatory systems. Pulmonary hypertension is characterized by elevated blood pressure in the pulmonary arteries which can lead to right heart strain and failure. In contrast, ARDS is primarily a lung condition resulting in severe oxygenation problems and causes damage to the alveoli and pulmonary capillaries. Signs and symptoms are different and develop gradually over time in pulmonary hypertension and progress rapidly in a matter of hours or days in ARDS (Rurua et al., 2023). Forced Expiratory Volume (FEV1) and Forced Vital Capacity (FVC) are critical lung function tests that provide valuable information about lung function and are used to assess and diagnose various pulmonary conditions. An increase in both of these values may indicate improved lung function or a positive response to treatments, whereas a decreased value typically suggests impaired lung function and possible disease (Rentzhog et al., 2017).
Fick’s Law is a concept that describes how gases like oxygen and carbon dioxide move across the alveolar-capillary membrane in the lungs which allows for gas exchange between the air in the alveoli and the bloodstream. It helps to explain how the structure and properties of the alveolar capillary membrane as well as the partial pressure differences influence the rate of oxygen uptake and carbon dioxide removal during respiration. This is critical for maintaining proper oxygen levels in the blood and eliminating CO2 (Andreucci et al., 2018).
References
Andreucci, D., Cirillo, E.N.M., Colangeli, M., Gabrielli, D. (2018). Fick and fokker-planck diffusion law in inhomogenous media. Journal of Statistical Physics, 174(1), 469-493. https://doi.org/10.1007/s10955-018-2187-6
Rentzhog, C.H., Janson, C., Berglund, L, Borres, M.P., Nordvall, L., Alving, K., Malinovschi, A. (2017). Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control. Clinical & Experimental Allergy, 47(12), 1546-1554. https://www.doi.org/10.1111/cea.13035
Rurua, M., Pahkoria, E., Sanikidze, T., Machvariani, K., Ormocadze, G., Jomidava, T., Dzidziguri, D., Ratiani, L. (2023). Impact of the angiotensin-converting enzyme (ace) inhibitors on the course of the acute respiratory distress syndrome (ards) developed during covid-19 and other severe respiratory infections under hyperferritinemia conditions: a cohort study. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 17(1), 1-9. https://www.doi.org/10.1177/11795484231180391
