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Any illness or condition that injures the lungs could cause ARDS. Greater than half of the people with ARDS develop it as a consequence of a severe, widespread infection (sepsis) or pneumonia. When the small air sacs (alveoli) and tiny blood vessels (capillaries) of the lungs are injured, blood and fluid leak into the spaces between the air sacs and ultimately into the sacs themselves. Collapse of many alveoli (a condition called atelectasis) may result due to a reduction in surfactant, a liquid that coats the inside surface of the alveoli and helps to maintain them open. Fluid in the alveoli and the collapse of many alveoli interfere with the movement of oxygen from inhaled air into the blood. Thus, the extent of oxygen in the blood decreases sharply. Movement of carbon dioxide from the blood to air that is exhaled is affected much less, and the extent of carbon dioxide in the blood adjustments little or no. Because respiratory failure in ARDS results mainly from low ranges of oxygen, it is considered hypoxemic respiratory failure. The decrease in the level of oxygen in the blood caused by ARDS and the leakage into the bloodstream of certain proteins (cytokines) produced by injured lung cells and white blood cells can result in inflammation and complications in different organs. Failure of several organs (a situation known as a number of organ system failure) might also outcome. Organ failure can begin soon after the start of ARDS or days or weeks later. Additionally, folks with ARDS are much less in a position to combat lung infections, they usually tend to develop bacterial pneumonia.
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