Because the ARDS Foundation realizes that people have a difficult time conceptualizing how quickly a patient become so critically ill when acute respiratory distress syndrome strikes, we felt it was important to illustrate this fact. To simply state that it is between twenty-four to forty-eight hours never seems to properly impress upon people just how quickly ARDS moves.
It was for this reason that we wanted to show with x-rays, how quickly ARDS can overtake the lungs sometimes within days, sometimes hours.
After all, a picture is worth a thousand words, isn’t it? These x-rays (radiographs) demonstrate the rapidity of ARDS and the need to start ventilatory support.
Case Study:
41-year old, female, caucasion went to the emergency room for dehydration, cough and fever.
X-ray on Day 1
Findings: An examination demonstrated a large right upper lobe infiltrate. Mass lesion suspicious for pneumonia or malignancy. The right lower lobe and left lung remain clear. Heart size and pulmonary vasculature are within normal limits. Patient was admitted to the hospital.
X-ray on Day 2
There is still dense infiltrate involving the right upper lobe particularly the anterior and posterior segments with some sparing of the apicla segment. In the interval, however, there has been development of a parenchymal infiltrate at the right base most likely involving right middle and lower loves with evidence of bilateral pleural effusions.
X-ray on Day 3
There is a worsening right lung opacity consistent with right upper lobe mass with increasing effusions and basilar infiltrates. The left lung showed new multifocal infiltrates and increasing effusion as well.
An endotracheal tube is present with the tip well above the carina. A nasogastic tube is seen with the tip in the stomach.
The ARDS Foundation especially thanks Dr. Willard Fry and the Marilyn Waitkus from the Multimedia Department at Evanston Northwestern Healthcare for their assistance to this project.
