Acute respiratory distress syndrome causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2], Brian Shaller, M.D. [3]


ARDS may be caused by either direct or indirect insults to the lung. Common causes of ARDS include pneumonia, sepsis, aspiration of gastric contents, and transfusion-related acute lung injury (TRALI).


Life Threatening Causes

ARDS is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.

Common Causes

ARDS may occur as the result of either a direct or indirect insult to the lungs:[1][2][3][4][5]

  • Direct insult
  • Indirect insult:

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning Mercury inhalation
Dental No underlying causes
Dermatologic Stevens-Johnson syndrome, toxic epidermal necrolysis[6]
Drug Side Effect Acetylsalicylic acid, ado-trastuzumab emtansine, afatinib, amiodarone, crizotinib, cytarabine, cytomegalovirus immune globulin, docetaxel, filgrastim, follitropin, gemcitabine, mitomycin, nitrofurantoin, sorafenib, tbo-filgrastim, urofollitropin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental Acute eosinophilic pneumonia, inhalation injury, near-drowning, surface burns
Gastroenterologic Aspiration of gastric contents, pancreatitis
Genetic No underlying causes
Hematologic Bone marrow transplantation, massive blood transfusion
Iatrogenic Bone marrow transplantation, cardiopulmonary bypass, massive blood transfusion, oxygen toxicity
Infectious Disease Acute eosinophilic pneumonia, ehrlichiosis, leptospirosis, malaria, miliary tuberculosis, pneumonia (bacterial, viral, fungal, or parasitic), sepsis, severe acute respiratory syndrome (SARS)
Musculoskeletal/Orthopedic Fat embolism, polytrauma
Neurologic Traumatic brain injury (TBI)
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Amniotic fluid embolism
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity Acetylsalicylic acid, heroin, naloxone
Psychiatric No underlying causes
Pulmonary Acute eosinophilic pneumonia, aspiration of gastric contents, Cryptogenic organizing pneumonia (COP), decompression sickness, fat embolism, lung transplantation, pneumonia
Renal/Electrolyte Uremia
Rheumatology/Immunology/Allergy Anaphylaxis, bone marrow transplantation, leukoagglutin reactions
Sexual No underlying causes
Trauma Pulmonary contusion, polytrauma, severe trauma, traumatic brain injury (TBI)
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


  1. Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ (1982). "Clinical predictors of the adult respiratory distress syndrome". Am J Surg. 144 (1): 124–30. PMID 7091520.
  2. The ARDS Definition Task Force*. “Acute Respiratory Distress Syndrome: The Berlin Definition.” JAMA 307, no. 23 (June 20, 2012): 2526–33. doi:10.1001/jama.2012.5669.
  3. Wheeler, Arthur P., and Gordon R. Bernard. “Acute Lung Injury and the Acute Respiratory Distress Syndrome: A Clinical Review.” Lancet (London, England) 369, no. 9572 (May 5, 2007): 1553–64. doi:10.1016/S0140-6736(07)60604-7.
  4. Sweeney, Rob Mac, and Daniel F. McAuley. “Acute Respiratory Distress Syndrome.” Lancet (London, England), April 28, 2016. doi:10.1016/S0140-6736(16)00578-X.
  5. Fowler, A. A., R. F. Hamman, J. T. Good, K. N. Benson, M. Baird, D. J. Eberle, T. L. Petty, and T. M. Hyers. “Adult Respiratory Distress Syndrome: Risk with Common Predispositions.” Annals of Internal Medicine 98, no. 5 Pt 1 (May 1983): 593–97.
  6. de Prost N, Mekontso-Dessap A, Valeyrie-Allanore L, Van Nhieu JT, Duong TA, Chosidow O; et al. (2014). "Acute respiratory failure in patients with toxic epidermal necrolysis: clinical features and factors associated with mechanical ventilation". Crit Care Med. 42 (1): 118–28. doi:10.1097/CCM.0b013e31829eb94f. PMID 23989174.