Weinacker A B, Vaszar L T
Department of Medicine, Division of Pulmonary and Critical Care, Stanford University Medical Center, Stanford, California 94305-5236, USA.
Annu Rev Med. 2001;52:221-37. doi: 10.1146/annurev.med.52.1.221.
The acute respiratory distress syndrome (ARDS) has been recognized for more than three decades as a cause of respiratory failure in patients with a variety of illnesses. Clinically, it is characterized by pulmonary edema, refractory hypoxemia, diffuse pulmonary infiltrates, and altered lung compliance. Pathologically, it is distinguished by infiltration of the lungs with inflammatory cells, interstitial and alveolar edema, hyaline membrane formation, and ultimately fibrosis. Although we have learned much about the pathophysiology of this inflammatory syndrome since its earliest descriptions, ARDS continues to claim the lives of 40%-70% of its victims. Many treatment strategies have been used to prevent or treat ARDS, but thus far the most encouraging strategy to prevent lung injury and improve survival is mechanical ventilation with low tidal volumes and high levels of positive end-expiratory pressure.
急性呼吸窘迫综合征（ARDS）三十多年来一直被认为是多种疾病患者呼吸衰竭的一个病因。临床上，其特征为肺水肿、难治性低氧血症、弥漫性肺部浸润以及肺顺应性改变。病理上，其特点是肺部有炎症细胞浸润、间质和肺泡水肿、透明膜形成，最终出现纤维化。尽管自最早描述以来我们对这种炎症综合征的病理生理学已了解很多，但ARDS仍导致40%-70%的患者死亡。许多治疗策略已被用于预防或治疗ARDS，但迄今为止，预防肺损伤和提高生存率最令人鼓舞的策略是采用低潮气量和高水平呼气末正压的机械通气。
