Distress (medicine)

In medicine, distress is an aversive state in which a person is unable to adapt completely to stressors and their resulting stress and shows maladaptive behaviors. It can be evident in the presence of various phenomena, such as inappropriate social interaction (e.g., aggression, passivity, or withdrawal).

Distress is the opposite of eustress, a positive stress that motivates people.

Risk factors

Stress can be created by influences such as work, school, peers or co-workers, family and death. Other influences vary by age.

People under constant distress are more likely to become sick, mentally or physically. There is a clear response association between psychological distress and major causes of mortality across the full range of distress.

Higher education has been linked to a reduction in psyochological distress in both men and women, and these effects persist throughout the aging process, not just immediately after receiving education. However, this link does lessen with age. The major mechanism by which higher education plays a role on reducing stress in men is more so related to labor-market resources rather than social resources as in women.

Medicine

Medicine (British English ⁱ/ˈmɛdsᵻn/; American English ⁱ/ˈmɛdᵻsᵻn/) is the science and practice of the diagnosis, treatment, and prevention of disease. The word medicine is derived from Latin medicus, meaning "a physician". Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness.

Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

Medicine has existed for thousands of years, during most of which it was an art (an area of skill and knowledge) frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism. In recent centuries, since the advent of science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science). While stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.

Respiratory failure

Respiratory failure results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide or both cannot be kept at normal levels. A drop in the oxygen carried in blood is known as hypoxemia; a rise in arterial carbon dioxide levels is called hypercapnia. Respiratory failure is classified as either Type I or Type II, based on whether or not there is a high carbon dioxide level.

The normal partial pressure reference values are: oxygen PaO₂ more than 80 mmHg (11 kPa), and carbon dioxide PaCO₂ lesser than 45 mmHg (6.0 kPa).

Types

Type 1

Type 1 respiratory failure is defined as a low level of oxygen in the blood (hypoxemia) without an increased level of carbon dioxide in the blood (hypercapnia), and indeed the P_aCO₂ may be normal or low. It is typically caused by a ventilation/perfusion (V/Q) mismatch; the volume of air flowing in and out of the lungs is not matched with the flow of blood to the lungs. The basic defect in type 1 respiratory failure is failure of oxygenation characterized by:

Infant respiratory distress syndrome

Infant respiratory distress syndrome (IRDS), also called neonatal respiratory distress syndrome,respiratory distress syndrome of newborn, or increasingly surfactant deficiency disorder (SDD), and previously called hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. It can also be a consequence of neonatal infection. It can also result from a genetic problem with the production of surfactant associated proteins. IRDS affects about 1% of newborn infants and is the leading cause of death in preterm infants. The incidence decreases with advancing gestational age, from about 50% in babies born at 26–28 weeks, to about 25% at 30–31 weeks. The syndrome is more frequent in infants of diabetic mothers and in the second born of premature twins.

IRDS is distinct from pulmonary hypoplasia, another leading cause of neonatal death that involves respiratory distress.

Acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS), previously known as respiratory distress syndrome (RDS), acute lung injury, adult respiratory distress syndrome, or shock lung, is a severe, life-threatening medical condition characterized by widespread inflammation in the lungs. ARDS may be triggered by various clinical insults such as trauma, pneumonia and sepsis.

ARDS is a disease of the microscopic air sacs of the lungs (alveoli) that leads to decreased exchange of oxygen and carbon dioxide (gas exchange). ARDS is associated with several pathologic changes: the release of inflammatory chemicals, breakdown of the cells lining the lung's blood vessels, surfactant loss leading to increased surface tension in the lung, fluid accumulation in the lung, and excessive scarring. The hallmark of ARDS is diffuse alveolar damage (DAD), which is acute inflammation of alveolar walls with hyaline membranes.

The syndrome has a high mortality between 20 and 50%. The mortality rate with ARDS varies widely based on disease severity, the patient's age, and the presence of other underlying medical conditions.