What is residual ARDS(Acute respritory distress syndrome)?

My husband had ARDS last year and was in ICU for 50 days. He just went to the doctor with a heavy cough and was told by way of chest x-ray that he has residual ARDS. Is this normal or should I be panicked?

Just by looking at a Chest X-ray? Did the X-ray have a ground-glass look? Infiltrates? (If you have a copy of the Radiologist's interpretation, it would probably pin-point what he is seeing)

Your physician probably just means his lungs are inflamed. Or implying that he hasn't quite gotten over the acute episode and is now in somewhat of a chronic condition. I think that would be the best answer... (as "residual acute" doesn't make sense). It depends on how long ago your husband has been out of the ICU.

It's inaccurate to say your husband's condition is "chronically acute".

Since your husband was in the ICU for 50 days, it's more than likely some or all of your husband's ARDS was attributed to sepsis (infection). So, it could be inferred that your MD is claiming your husband hasn't quite gotten over his previous infection...

We could probably answer this question if we knew more about your husband's previous stay at the ICU. What is his history? Smoking history? History of infection? Indications (reasons) for his initial admission to the hospital. Previous surgeries?

Not all that information is necessary... as I suspect my initial guess is correct. He just mixed up his words and used the "term" ARDS incorrectly. Perhaps "lingering infection" would be a better assessment. Or perhaps re-exacerbation of lung injury.

If you want the textbook definition of ARDS check the link I've left in the source list below.

UPDATE: "...heavy lung markings..." as noted by the Radiologist read does suggest there is some permanent damage to the lungs. (as damurray69 has mentioned below) You can do a Wiki search on "Pulmonary Fibrosis" for further information on the scarring process. I would also agree with damurray69 on his notes on mechanical ventilation. While it isn't mentioned how long your husband was on a ventilator in his 50 days... we can probably infer that he was on the ventilator for quite some time. With ARDS/Sepsis you can require a good deal of atypical mechanical ventilation (e.g. Pressure Controlled or Pressure Regulated Volume Control, etc...). This is usually secondary to lost of lung compliance during disease process or secondary to the mechanical ventilation itself.

I wouldn't be "panicked" as you are worried about... but because of lung injury, your husband may encounter problems in the future related to the scarring. However, if he has a strong cough... that's actually something positive. He may also have interstitial lung impairment and diffusion problems (impairment of gas exchange in the capillary bed). You can assess this damage with a Full Pulmonary Function Test (when doing the test, ask if they are measuring DLCO).

So to answer your question of "...is this normal.." I would say the chest x-ray interpretation is consistent with his history of his 50 days in the ICU which, more than likely, included days on mechanical ventilation. Based on the information you've given, he's probably going to be okay (but I haven't assessed him myself).

What Is ARDS?

Acute respiratory distress syndrome (ARDS) is breathing failure that can occur in critically ill persons with underlying illnesses. It is not a specific disease. Instead, it is a life-threatening condition that occurs when there is severe fluid buildup in both lungs. The fluid buildup prevents the lungs from working properly鈥攖hat is, allowing the transfer of oxygen from air into the body and carbon dioxide out of the body into the air.

In ARDS, the tiny blood vessels (capillaries) in the lungs or the air sacs (alveoli (al-VEE-uhl-eye)) are damaged because of an infection, injury, blood loss, or inhalation injury. Fluid leaks from the blood vessels into air sacs of the lungs. While some air sacs fill with fluid, others collapse. When the air sacs collapse or fill up with fluid, the lungs can no longer fill properly with air and the lungs become stiff. Without air entering the lungs properly, the amount of oxygen in the blood drops. When this happens, the person with ARDS must be given extra oxygen and may need the help of a breathing machine.

Breathing failure can occur very quickly after the condition begins. It may take only 1 or 2 days for fluid to build up. The process that causes ARDS may continue for weeks. If scarring occurs, this will make it harder for the lungs to take in oxygen and get rid of carbon dioxide.

In the past, only about 4 out of 10 people who developed ARDS survived. But today, with good care in a hospital's intensive or critical care unit, many people (about 7 out of 10) with ARDS survive. Although many people who survive ARDS make a full recovery, some survivors have lasting damage to their lungs.

ARDS is a severe illness that can have lasting effects. If your husband was on the ventilator in the ICU for that long he could have some residual scarring or lung damage from the ARDS as well as the mechanical ventilation. Usually, in ARDS, the lungs become very stiff, or non-compliant. This means that the pressures needed to move the air in and out of his lungs are much higher than normal, and this can cause some lingering damage. This might be what the Dr was referring to, not actual ARDS but rather the damage or scarring from his previous illness.