Pneumonia and ARDS – the upcoming epidemic

Islamabad

With the change in weather conditions, serious respiratory tract infections including influenza, pneumonia and acute respiratory distress syndrome (ARDS) have started hitting population in this region of the country.

Pneumonia and ARDS which are more fatal forms of respiratory tract infections claim a good number of lives every year in the region and according to many health experts, it is so because majority of our population do not take measures to avoid these.

Data collected by ‘The News’ has revealed that in public sector hospitals of the federal capital, the ARDS claimed well over 100 lives last year mainly from October to December.

In dry and cold weather conditions like the existing one, the atmosphere is filled with pollutants including dust and toxins and studies reveal that breathing in harmful substances including dense smoke and chemical fumes triggers ARDS.

The number of patients of pneumonia and ARDS is continuously on the rise as the respiratory tract infections have already taken shape of an outbreak, said Senior Consultant Intensive Care Medicine at Pakistan Institute of Medical Sciences Dr. Muhammad Haroon while talking to ‘The News’ on Monday.

He said the PIMS has been receiving well over 150 patients of respiratory tract infections with serious complaints per week who require hospitalisation. Of these, 20 to 30 per cent need ventilator while 70 per cent may get cure after hospitalisation, he said.

He added that pneumonia, the lower respiratory tract infection is rising in striking proportions and almost all healthcare facilities including public sector and private ones have started receiving significant number of patients with the problem.

All patients with cough, fever, lethargy and thick viscid sputum for over three days should undergo a chest X RAY to avoid complications of the infection, he said.

He added that the most fatal and dangerous complication of pneumonia is ARDS, a condition that develops rapidly in which patient with chest infection cannot maintain oxygenation level due to lungs’ dysfunction. The accumulation of fluid and secretions in airspaces impair the transfer of oxygen to blood, he said.

Dr. Haroon added that majority of patients of ARDS reported last year at the time of onset of winter were the ones having flu, pneumonia, chest infections and other such ailments.

He added that an outbreak of flu is expected due to smog in the air and cold weather. Studies reveal that the ARDS patient has severe air hunger and suffocation that abruptly starts within few hours and progress rapidly. Both lungs are filled with fluid that clogs the airways drowning patients in their own secretions, he said.

He added that the only way out is high index of suspicion, early diagnosis and immediate treatment in an ICU.

Studies reveal that the ARDS patient needs ICU care for at least four weeks afterwards recovery starts and complete cure takes three to six months generally.

Dr. Haroon said data shows that mortality after developing ARDS ranges from 90 to 100 per cent in non-ventilated patients in Pakistan.

The cause of death in majority of cases is late presentation to the ICU while majority of patients die of the ARDS were those suffering from asthma, COPD (Chronic Obstructive Pulmonary Disease) and diabetes along with critical complications, he said.

He added that there are many other causes of ARDS like severe infections, sepsis, pancreatitis, burns etc but respiratory infections are the most common in winter. He said individuals should get flu vaccination and those with pre existing lung diseases like asthma and COPD should get pneumonia vaccination as well.

He explains that ARDS initially starts with lungs failure but involves other organs including heart, liver, kidneys and brain by doing hypoxic ischemic damage in all body. Young adults have better survival rates, he said.