Complications associated with the adult respiratory distress syndrome

The adult respiratory distress syndrome is frequently fatal. Attempts to decrease mortality must include attention to pulmonary and extrapulmonary complications of this syndrome. Pulmonary complications include pulmonary emboli, barotrauma, fibrosis, and pneumonia. Mechanical ventilation, Swan-Ganz catheters, and tracheal intubation also result in pulmonary complications. Extrapulmonary complications such as gastrointestinal hemorrhage, renal failure, infection, and thrombocytopenia may increase mortality. The incidence of gastrointestinal hemorrhage can be reduced with prophylactic antacids. Likewise, the incidence of pulmonary emboli can be reduced with low dose heparin. Careful attention to patients' urine output, fluid, and electrolyte status as well as vigorous cardiovascular support are also essential to decrease renal complications. Early diagnosis, aggressive treatment, and prophylaxis of complications should increase survival.