Decoding wet lung condition 

HYDERABAD: “Wet lung”, also known as acute respiratory distress syndrome (ARDS), is a condition that occurs when the lungs are filled with fluid instead of air. This fluid could be pus from infection, fluid backed up in the lungs from heart disease or blood from either lung or heart disease. A wet lung can affect anyone regardless of age. It should be treated as a medical emergency and can be life-threatening if left untreated. 

Symptoms
Depending on the underlying cause, signs and symptoms of wet lung can vary. The primary symptom of wet lung is sudden shortness of breath. It usually presents within 12-48 hours from the onset of the lung injury. Laboured and fast breathing are also some of the characteristics of wet lung. Additional symptoms can occur due to these breathing difficulties, such as coughing, dizziness, tiredness, cyanosis (when the tips of the fingers and toes take on a bluish hue), or headaches. Other symptoms may range depending on the underlying cause like sepsis which may cause fever and low blood pressure.

Causes
“There are multiple potential causes of wet lung and they all can specifically affect the alveoli, by causing injury or death of the lung tissue. These causes be classified as direct or indirect lung injury. While direct lung injuries affect only the lungs, indirect lung injury occurs because of body-wide, systemic problems. Several different conditions and illnesses can also lead to wet lung/ARDS. These may include viral or bacterial infections, such as pneumonia, flu, or COVID-19, sepsis or septic shock, traumatic lung injuries, including burns, chemical inhalation, accidental inhalation of vomit or food, and acute pancreatitis,” shares Dr Deepak Sharma, Consultant Pulmonologist, Ujala Cygnus Group of Hospitals.

Risk factors
Advanced age and a history of previous organ dysfunction, such as liver dysfunction from cirrhosis are the greatest risk factors for death due to wet lung. It has also been seen that people who developed ARDS during a COVID-19 infection were at a greater risk of developing long-COVID, or COVID-related symptoms that last more than a few weeks after infection. Obesity appears to increase this risk. Although most people recover from ARDS, it can be fatal.

Diagnosis
Wet lung is initially diagnosed by evaluating the history of the symptoms, the individual’s medical history, and a physical examination. A doctor will often hear crackle sounds while assessing an individual with wet lung when he/she breathes in and out. Apart from that, the patient usually presents with low oxygen levels. 

If the initial evaluation indicates wet lung, then the doctor will advise blood tests and imaging to support the diagnosis and determine the underlying condition. In such cases, blood tests often reveal hypoxemia. It refers to significantly low levels of oxygen in the blood and may also indicate acidosis. In addition, chest X-rays may show what caused the low oxygen levels, such as fluid in the alveoli. A CT scan or computed tomography scan may also be conducted. As part of the diagnosis sometimes, an echocardiogram is also required to rule out heart problems.

Treatment
Treatment of wet lung is done by managing the symptoms and treating the underlying cause. “The key goals of the treatment are to improve blood oxygen levels to prevent organ damage and treat the injury or condition that caused it. The patient may undergo breathing support, medications, or other therapies. Treatment is different for each person, depending upon symptoms and underlying causes. In severe cases patient may need ventilator support especially those with multi-organ dysfunction and prognosis of such patients can be poor,” says Dr Deepak. Overall, treatments can help manage symptoms and help you recover. However, their effectiveness depends on a case-to-case basis and the underlying cause.