What Is Acute Lung Injury (ALI)?
Acute lung injury (ALI) is an acute respiratory failure characterized by hypoxemia (low oxygen level in the blood) and the development of bilateral pulmonary infiltrate without left atrial hypertension. The severity of hypoxemia is more in the case of acute respiratory distress syndrome (ARDS). Trauma, multiple injuries, or sepsis are the main factors causing acute lung injury. It is also influenced by age, genetics, and lifestyle factors like excessive smoking or alcohol consumption.
What Is Sepsis-Induced Acute Lung Injury?
An injury to the epithelial lining of the lungs or pulmonary endothelial cells causes sepsis-induced acute lung injury. Sepsis is a condition in which the body develops an excessive immune response against infections. It is a life-threatening complication. Sepsis is a major factor responsible for acute lung injury. In such cases, the cells present in the lining of the lungs and respiratory structures (alveolar epithelial cells) get destroyed. This increases the permeability of the epithelial lining, leading to an inward movement of edematous fluid. These changes cause cellular death or apoptosis and cell injuries.
The following are the symptoms of acute lung injury:
- Shortness of breath.
- Exertion while breathing.
- Tiredness.
- Confusion.
- Rapid breathing.
Sepsis-induced acute lung injury may be diagnosed with the help of imaging techniques like chest X-rays or computed tomography (CT) scans. The doctor may also suggest taking lab tests (to check for the presence of any particular infections or diseases) to measure the oxygen level in the blood.
What Are the Complications of Sepsis-Induced Acute Lung Infection?
Some of the complications associated with sepsis-induced acute lung infection include the following:
- Deep vein thrombosis (the formation of a blood clot within a vein) may develop due to blood clot formation. This may be accompanied by pain and swelling.
- The air may get collected outside the lung and within the pleural cavity, leading to pneumothorax. This may be due to the injury caused by the ventilator.
- The muscles may get weak due to acute lung infection.
- The patient may not be able to think and will be confused or disoriented, leading to a mental state called delirium.
- The lung tissues may get scarred or damaged, leading to lung fibrosis. The scarred tissue will be thick compared to normal tissues and impair the lungs' regular functioning.
- The mental fitness of the patient may get affected, making the patient depressed or anxious.
How Is Sepsis-Induced Acute Lung Infection Treated and Managed?
A patient having sepsis-induced acute lung infection will be admitted to an intensive care unit (ICU). Sepsis-induced acute lung infection (ALI) can be treated by the following methods:
- High-Flow Nasal Cannula and Noninvasive Ventilation: Hypoxemia occurs in the case of ALI. High-flow nasal cannula delivers humidified hundred percent oxygen. Providing patient support using this method prevents emergency cases. Non-invasive ventilation delivers oxygen into the lungs without endotracheal intubation. To manage hypoxia, supplemental or mechanical methods are usually adopted. Supplemental oxygen delivery is a temporary measure by which oxygen will be supplied with the help of masks.
- Invasive Mechanical Ventilation: By this method, an endotracheal tube or tracheostomy tube will be used for ventilation. These tubes go through the mouth or neck and attach to the respiratory passages. During the technique, the patient will be given sedation, and the tube will be placed. The tube will then be attached to the ventilator. The ventilator will help with breathing.
- Neuromuscular Blockade: In the early cases of sepsis-induced acute lung infection, neuromuscular blocking agents may be helpful. It may reduce inflammation related to sepsis and improve oxygen consumption and cardiac output.
- Medication: Medication will be given to the patients to treat the underlying infections. Medication will also reduce inflammation, discomfort, and pain. Sedatives will also be given to patients with sepsis-induced acute lung infection.
- Fluid Management: The patient should be provided with intravenous fluids. This is a very crucial step, as too much fluid can increase the chance of intrapulmonary edema, and too little fluid can affect the heart and other organs, leading to stroke.
- Prone Positioning: In prone positioning protocol, the patient will be made to lie down on the abdomen and be monitored. A patient in an ICU or hospital bed will usually be supine. Prone positioning may improve arterial blood gas, relieves the compressed lungs, and reopens the respiratory passages, thus helping the patient relieve the symptoms.
The complications due to a sepsis-induced acute lung infection can be managed by the following steps:
- Pain management with the help of medicines.
- Clot prevention by giving blood thinners.
- Physical therapy to prevent the weakening of the muscles.
- Determination of the apt time to remove endotracheal or tracheostomy tubes.
- Minimizing the chances of pulmonary fluid buildup.
What Are the Tips to Follow While Recovering From Sepsis-Induced Acute Lung Infection?
Recovering from sepsis-induced acute lung infection requires proper care and effort. Therefore, taking proper care during and after the recovery period is important.
- The patient may not be able to do the routine tasks themselves. Asking for help in such cases is essential to retrain for routine activities and getting back on life’s track.
- Quitting the habit of smoking is essential while recovering from a sepsis-induced acute lung infection. Smoking and secondhand smoke can be damaging to the lungs.
- Rehabilitation programs may help the patient gain knowledge related to the medical condition. Pulmonary rehabilitation programs train patients to exercise to make the lung fit and healthy.
- Symptoms affecting mental health, like depression or anxiety, can develop in the patient. The patient should consider consulting a professional and attending counseling and related programs to get a cure.
Conclusion
Sepsis-induced acute lung injury is a type of lung injury developing due to sepsis. Infection, along with injuries, are the main factors responsible for the condition. The condition can be severe and may require admission to an intensive care unit or ICU. Healthcare professionals offer required treatments based on the health abilities and symptoms of the patient. During recovery, the patient should follow a healthy lifestyle and consider attending pulmonary rehabilitation programs.
