Respiratory support

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

Depending on the severity of your ARDS, your doctor may recommend 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. This electronic breathing equipment helps keep your airways open by blowing air through a face mask.
• A fan . Your doctor will adjust the ventilator settings to help prevent further damage to your lung tissue. If the ventilator is helping to restore oxygen levels in your blood and it is easier to breathe on your own, your doctor can turn off the ventilator to see if you are ready to remove it completely. Some people switch from a ventilator to portable oxygen therapy. Risks of ventilation include pneumonia and pneumothorax, which can cause your lungs to collapse.

Medicines

Your doctor can recommend medications to relieve symptoms, treat the underlying cause, or prevent complications if you are in a hospital. These can include:

• Acid-lowering drugs to prevent stress ulcers , which can cause bleeding in the gut vcause.
• Antibiotics to treat or prevent infections. If you are on a ventilator, your health care team may perform tests, such as lung fluid lab tests or CT scans, to look for signs of a new infection.
• Blood thinners to prevent blood clots from forming or getting bigger. Heparin is a common blood thinner for adults.
• Muscle relaxants to help prevent coughing or retching during ventilation or to reduce the amount of oxygen your body needs.
• Painkillers, which your doctor can prescribe depending on your needs.
• Sedatives to relieve anxiety, make breathing easier on a ventilator, or lower your body's oxygen demand. Sometimes your doctor may combine a sedative with another medicine to make it easier to give 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), thinking or memory problems, or delay in removing the ventilator.

Other treatments

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 organs of the body.
• Extracorporeal membrane oxygenation (ECMO) or a similar device, especially for severe ARDS. ECMO helps when ventilation alone cannot provide enough oxygen or while a patient is waiting for a lung transplant. ECMO acts like an artificial lung, removing carbon dioxide and pumping oxygenated blood back into the body.
• Fluid management. Your healthcare team checks the fluid balance in your body. Low blood pressure can occur if the fluid in your blood vessels is low. This can prevent oxygen from getting into your organs. To help restore balance, your doctor may give you fluid through an intravenous (IV) line. If you have too much fluid in the lungs, your doctor can give you medicines that help your body get rid of it.
• Nutritional support. You may need a feeding tube to make sure you are getting enough of the right nutrients while on a ventilator.
• Physical therapy to maintain muscle strength and prevent ulcers. Exercise can help shorten the time you spend on ventilation and improve recovery after you leave the hospital.
• Position your body. For severe ARDS, your doctor may recommend that you lie face down most of the time, which allows more oxygen to get into your lungs.