Diagnosing & Treating Acute Respiratory Distress Syndrome

Fluids

Managing IV fluids for patients with acute respiratory distress syndrome is challenging. The hypoxic patient will need sufficient fluid replacement to increase perfusion of the tissues, without increasing edema in the lungs. Early in the disease, adding fluid to increase tissue perfusion is recommended. If pulmonary edema worsens, fluids should be restricted. The use of diuretics to remove the fluid in the lungs is controversial since the fluid is primarily inflammatory exudates with a high protein content and little water. Diuretics may also decrease cardiac output and reduce the oxygenation of tissues. Parenteral fluid therapy consists of crystalloids like five percent dextrose, blood products, electrolytes, and nutrient solutions. Hypertonic dextrose can be used to osmotically pull fluid from the lungs to permit better gas exchange. A feeding tube will be inserted for long-term nutrition.

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