The long-lasting effects of the acute respiratory distress syndrome

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury common in critically ill patients and characterized by significant morbidity and mortality. It frequently manifests long-lasting effects beyond hospitalization, from cognitive impairment to physical weakness.Areas covered: Several complications of ARDS have been identified in patients after hospital discharge. The authors conducted literature searches to identify observational studies, randomized clinical trials, systematic reviews, and guidelines. A summary of is presented here to outline the sequelae of ARDS and their risk factors with a focus on the limited but growing research into possible therapies. Long term sequelae of ARDS commonly identified in the literature include long-term cognitive impairment, psychological morbidities, neuromuscular weakness, pulmonary dysfunction, and ongoing healthcare utilization with reduced quality of life.Expert opinion: Given the public health significance of long-term complications following ARDS, the development of new therapies for prevention and treatment is of vital importance. Furthering knowledge of the pathophysiology of these impairments will provide a framework to develop new therapeutic targets to fuel future clinical trials in this area of critical care medicine.

Keywords: acute respiratory distress syndrome; long-term outcomes.

Figure 1.

Relationship between acute manifestations of ARDS and its long-term sequelae.

Figure 2.

Computed tomography (CT) image of the chest of an ARDS survivor with fibrotic changes in the lungs at 18 months after ARDS.(Reproduced with permission of the © ERS 2020: European Respiratory Journal 43(1) 276,285; DOI: 10.1183/09031936.00196412 Published 31 December 2013).