Breathe easy: For victims of ARDS, there is local help

Sunday, Dec. 19, 1999 | 10:05 a.m.

There is a mysterious killer on the loose, preying on the weak, the ill and the injured.

It may claim as many as 75,000 lives a year, according to those who are working to alert the country about the existence of the butcher that strikes without warning and without prejudice or bias.

If the number they use is even close to being accurate, and officials say it is impossible to tell for sure, then this cloaked killer is one of the leading causes of death in America -- falling behind heart disease, cancer and strokes.

The killer is called ARDS, the acronym used by most people familiar with Acute Respiratory Distress Syndrome.

ARDS, probably is as old as man but not officially identified till 1967, has a number of aliases.

Adult Respiratory Distress Syndrome. White Lung Disease. Shock Lung.

Doctors often saw it during the Vietnam War. There it was called Da Nang Lung.

Because of its nature, it is probably more common in war than peace.

Because it is associated with traumatic injuries and severe infections, it is most common in trauma centers and intensive care units.

Its M.O. is almost always the same.

The American Lung Association describes ARDS as "the rapid onset of progressive malfunction of the lungs, especially with regard to the ability to take in oxygen."

According to the Harborview Medical Center in Seattle, part of a group of 10 ARDS research centers, ARDS causes the lungs to become inflamed and prevents blood from adequately carrying oxygen throughout the body. In more acute cases, this can result in organ failure and death.

ARDS does not strike alone. It invades the body's system disguised by some other medical condition, a condition that initially is the more severe problem but quickly becomes the lesser of two evils.

ARDS may be triggered by a number of things -- massive infection (sepsis), physical injury to any part of the body (trauma), debilitating disease (cancer, HIV) or some other condition.

As explained by Harborview literature, "when a person is very sick or the body is severely injured, some chemical signals are released into the blood stream. These signals reach the lung and the lung reacts to these messages by becoming inflamed, thus causing lung failure."

The young and the strong are more likely to survive an onset of ARDS than the old and weak. The American Lung Association says in half the cases ARDS occurs within 24 hours of the catalytic illness and in almost all cases within three days.

Treatment for those who suffer from ARDS consists of mechanical ventilation along with fluid removal and a supportive breathing technique called "positive end expiratory pressure (PEEP)."

These are combined with continuing treatment of the original illness or injury.

Sometimes patients are put into a drug-induced coma because of the discomfort of a breathing tube that may be inserted down one's nose or throat or inserted through an incision the trachea for days or weeks at a time.

About 50 percent of the estimated 150,000 people a year who get ARDS die. Many of the 50 percent who survive are impaired for the rest of their lives.

ARDS, if not fatal, can destroy your kidneys, your liver or other vital organs. In some cases, it can rob you of your ability to think clearly.

Boulder City residents Sue and Mike Peterson, who moved from Wisconsin last summer, are among several co-founders of a national organization called ARDS Support.

The purpose of the organization is to encourage more research, to be a source of communication and to provide emotional support for those who need it.

"We want to give people hope and encouragement," she said.

Out of their travel trailer, using the Internet, the Petersons maintain contact with people around the country who are concerned about ARDS.

Unfortunately, they say, people don't become concerned about it till they, or one of their loved ones, become afflicted.

"Many people in the medical field haven't even heard of it," said Sue Peterson, who retired early to spread the word about ARDS.

Peterson became passionate about her message after her brother, John Grim, 41, was stricken by ARDS and she watched him deteriorate from a strong, vigorous man to a man who is physically weak and at constant risk of other illnesses.

The former communications specialist learned how little the general public knows about ARDS and is determined to change that.

Grim was one of the lucky ones. He survived and became one of the co-founders of ARDS Support.

But many others have not been so lucky. ARDS Support routinely carries the names of those who are stricken, and those who have died.

The husband of Las Vegas resident Jackie Rodack Binder was one of those who died. Ray Binder, a former firefighter with the North Las Vegas Fire Department and a Clark County coroner, died in January.

"He had lung cancer, and that's what is on his death certificate," Jackie Binder, a member of ARDS Support, said. But she said he died while in a drug-induced coma for treatment of ARDS.

"He had part of his lung removed during surgery," she said. "Two or three days later ARDS developed. That led to multiple organ failure. Three weeks later he died, without ever coming out of the coma. His heart couldn't take it. It was a nightmare."

Dr. Leonard Hudson, head of Pulmonary and Critical Care Unit of Harborview, says his clinic treats about 100 ARDS cases per year.

"As many people die of ARDS each year as with breast cancer," Hudson said.

He said it probably doesn't receive the attention of other major killers "because it doesn't have a catchy name and it is a complication that occurs most often in the critically ill."

Hudson said that though a lot of lab research is being done, there isn't enough clinical research in which treatments are applied to humans rather than lab animals.

"We need to understand how the mechanism of inflammation that leads to injury to the lungs works," he said.

Hudson said researchers are trying to understand the underlying conditions that may predispose a person to get ARDS and to come up with preventative measures.

Dr. Jay Turner, a professor and chief of pulmonary and critical care with the University of Nevada School of Medicine, cautions that patients should not be overly concerned about ARDS.

Not every critically ill patient gets ARDS and not every ARDS patient dies.

"Just because a patient may have ARDS doesn't mean we will stop their care," Turner said. "It is not necessarily a fatal disease where you just give up automatically."

While there may be some medical professionals who are not familiar with ARDS, Turner says "I would think virtually all physicians are familiar with it ... although not every physician participates (in ARDS treatments)."

He said a lot of ARDS research is being done today, but it is being done in conjunction with other ailments such as cancer and heart disease.

Turner said earlier approaches to research may have been too simplistic in their efforts to find an ARDS treatment.

"Researchers thought they could develop one magic bullet, but so far they have not been able to," he said.

(For more information go to the ARDS website at ards.org or e-mail Sue Peterson ad sue@ards.org.)

archive