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Complications and Outcomes of Acute Respiratory Distress Syndrome

DiSilvio, Briana MD; Young, Meilin MD; Gordon, Ayla MD; Malik, Khalid MD; Singh, Ashley PhDc, DNP, MSN, RN; Cheema, Tariq MD

doi: 10.1097/CNQ.0000000000000275
Original Articles

Acute respiratory distress syndrome (ARDS) is a disease associated with both short- and long-term complications. Acute complications include refractory respiratory failure requiring prolonged dependence on mechanical ventilation and the subsequent need for tracheostomy and gastrostomy tubes, protracted immobilization, and lengthy stays in the intensive care unit resulting in delirium, critical illness myopathy, and polyneuropathy, as well as secondary nosocomial infections. Chronic adverse outcomes of ARDS include irreversible changes such as fibrosis, tracheal stenosis from prolonged tracheostomy tube placement, pulmonary function decline, cognitive impairment and memory loss, posttraumatic stress disorder, depression, anxiety, muscle weakness, ambulatory dysfunction, and an overall poor quality of life. The degree of disability in ARDS survivors is heterogeneous and can be evident even years after hospitalization. Although survival rates have improved over the past 4 decades, mortality remains significant with rates reported as high as 40%. Despite advancements in management, the causes of death in ARDS have remained relatively unchanged since the 1980s with sepsis/septic shock and multiorgan failure at the top of the list.

Division of Pulmonary Critical Care, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs DiSilvio, Young, Gordon, Malik, and Cheema); and Nursing, Chatham University, Pittsburgh, Pennsylvania (Dr Singh).

Correspondence: Briana DiSilvio, MD, Division of Pulmonary Critical Care, Allegheny General Hospital, Allegheny Health Network, 320 E North Ave, Pittsburgh, PA 15212 (

The authors of this manuscript have no disclosures to report.

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