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What is Acute respiratory Distress Syndrome?

Acute respiratory Distress Syndrome (ARDS) describes a type of respiratory failure caused by specific injury of the alveoli surfaces within the lungs. The injury or insult to the tissue lining the lungs can be initially quite mild. It can result from direct trauma due to foreign bodies, or from an unrelated infection or even an injury to another part of the body. This results in a cascade reaction that impedes the lung tissues ability to exchange Oxygen (O2) and Carbon Dioxide (CO2). Which in turn creates blood gas imbalance and subsequent respiratory distress.

What causes Acute respiratory Distress Syndrome?

Acute respiratory Distress Syndrome occurs when damage is inflicted to the epithelial cells lining the surface of the Alveoli. These epithelial cells are split into two distinct types, the first makes up the bulk of the cellular wall structure, the second provides more specialised functions including rapid cellular proliferation following injury.

The type 1 cells can be damaged quite easily and leads to increased transfer of fluids into the area, with decreased ability to clear said fluids. Type 2 cells can quickly rectify this damage and are hardier themselves, however, if they too are damaged then repairs are slow and may lead to excessive scarring and thickening of the alveolar cell walls. It is the fluid retention and subsequent lung tissue scarring that causes the respiratory distress.

There is no guaranteed cause of ARDS and the initial injury can be very minor making anticipation or prevention of the condition very difficult. Fortunately the frequency of incidence of ARDS is quite low, around 75 cases per 100,000 people. Although the risk quadruples for people over the age of 75 years.

Active cycle of breathing exercises supervised by a specialist physiotherapistAbove: Active cycle of breathing exercises supervised by a specialist physiotherapist

A minority of people whom develop ARDS will have no associated conditions that clearly led to its development. For the majority of people one or more of the listed conditions below will be the main triggers for developing ARDS. These risk factors could include;

  • Pneumonia
  • Bacterial infection
  • Sepsis
  • Soft tissue trauma or burns
  • Bone Fractures
  • Lung tissue abrasion or pressure injuries from accidents like near drowning
  • Chemical or acidic damage from drug overdose or aspiration of gastric acid.

How is Acute respiratory Distress Syndrome diagnosed?

ARDS typically presents as acute breathing difficulty that develops in the hours following a specific physical trauma. The inciting injury, as discussed above, does not always have to directly injure the lung tissue itself, just cause systemic imbalance. Symptoms will progress rapidly over the initial 12 to 48 hours, from breathlessness during activity to being breathless even at rest. Other symptoms may include;

  • Laboured breathing.
  • Blueish cast (cyanosis) to skins, lips and fingernail beds.
  • Anxiety.
  • Cold extremities from vasoconstriction.
  • Rapid respiratory rate.
  • Rapid Heart rate.

For more information on how physiotherapy can help you recover from ARDS, or to book yourself an assessment, please contact us via email at or ring us on 0330 088 7800.

What would a physiotherapy assessment for ARDS involve?

At, we want to gain as much information as possible about your condition to ensure we give you the best treatment. In your first appointment with us, our physiotherapists will carry out an assessment which has two parts:


A discussion between you and our physiotherapist to find out what symptoms you are experiencing, and how your condition is affecting you and your lifestyle.


An assessment to discern the presence of any pain, your current breathing pattern, respiration rate, lung volume and a series of special tests to identify the presence of any mucus retention and lung function impairment.

There can be great variation in the symptoms displayed, depending on the progression of the condition and any complicating factors. The assessment process will be important in identifying your current symptoms and needs, so that treatments can be targeted and effective.

What would physiotherapy treatment for ARDS involve?

At, Our physiotherapists will ensure you receive specialised treatment for your ARDS. Depending on the severity and duration of your ARDS, your treatment may involve:

  • Secretion clearance:
    • Effective / productive coughing techniques.
    • Postural drainage in sitting and lying.
    • Manual assistance, including percussion, vibrations and shaking.
  • Breathing technique retraining:
    • Controlling respiratory rate
    • Diaphragmatic breathing
    • Controlling / reducing breath volume
    • Relaxation breathing exercises
  • Education and Advice:
    • Illness cause and progression.
    • Effects of environmental and allergen factors, including smoking.
    • Medication management
    • Recognising signs of possible Asthmatic episodes.

At you will experience a personalised treatment session. Each appointment will be aimed at returning to your everyday activities and what you enjoy. It will be important to note that the respiratory physiotherapy we apply should be closely incorporated with other health care professional’s management of the client’s dietary, medical and counselling needs.

How can I arrange a physiotherapy assessment for ARDS?

If you have been diagnosed by your doctor as having suffered from ARDS and have symptoms affecting your breathing and lung clearance, you would benefit from an assessment with one of our experienced respiratory physiotherapists.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, and give you advice on self-management. To arrange an appointment please email or call 0330 088 7800.


ARDS is an acute respiratory condition that rapidly limits effective lung function, leaving people breathless and tired even after minor exertion. It predominately affects older people and can develop after a physically traumatic event or illness. If you are diagnosed with ARDS you will require emergency medical care as severe cases can lead to multiple organ failure.

We can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of lung function and comfort during your recovery. We can also advise on activity modification to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions.

For more information on how physiotherapy can help treat ARDS, or to book yourself an assessment, please contact us via email at or ring us on 0330 088 7800.

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