Respiratory Care Services, NH GA2, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco CA 94110, USA.
Respir Care. 2010 Feb;55(2):144-57; discussion 157-61.
In patients with acute respiratory distress syndrome (ARDS), inhaled vasodilator can result in important physiologic benefits (eg, improved hypoxemia, lower pulmonary arterial pressure, and improved right-ventricular function and cardiac output) without systemic hemodynamic effects. Inhaled nitric oxide (INO) and aerosolized prostacyclins are currently the most frequently used inhaled vasodilators. Inhaled prostacyclins are as effective physiologically as INO and cost less. Randomized controlled trials of INO in the treatment of ARDS have shown short-term physiologic benefits, but no benefit in long-term outcomes. No outcome studies have been reported on the use of prostacyclin in patients with ARDS. There is no role for the routine use of inhaled vasodilators in patients with ARDS. Inhaled vasodilator as a rescue therapy for severe refractory hypoxemia in patients with ARDS may be reasonable, but is controversial.
在急性呼吸窘迫综合征（ARDS）患者中，吸入血管扩张剂可带来重要的生理益处（例如，改善低氧血症、降低肺动脉压以及改善右心室功能和心输出量），而无全身血液动力学效应。吸入一氧化氮（INO）和雾化前列环素是目前最常使用的吸入性血管扩张剂。吸入前列环素在生理上与 INO 同样有效，且成本更低。INO 治疗 ARDS 的随机对照试验显示短期生理益处，但对长期结局没有益处。关于 ARDS 患者使用前列环素的结果研究尚未报道。常规使用吸入性血管扩张剂治疗 ARDS 并无作用。吸入性血管扩张剂作为 ARDS 患者严重难治性低氧血症的抢救治疗可能合理，但存在争议。
