Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, Australia Sydney Medical School, Australia.
Paediatr Respir Rev. 2010 Sep;11(3):171-5; quiz 175-6. doi: 10.1016/j.prrv.2010.03.001. Epub 2010 Apr 15.
Acute lung injury(ALI) is an important condition in critically ill children, contributing to overall mortality and morbidity. ALI represents the severe spectrum of lower airways disease in children. It is the pathological culmination of diseases such as pneumonia and sepsis. These conditions elicit a host response, which results in a clinically and radiologically defined pulmonary syndrome, leading to additional physiological burden. Despite ALI being well described in the paediatric age group, its management has been largely based on adult studies. Ventilatory support with low tidal volumes, positive end expiratory pressure(PEEP) and permissive hypercapnoea are the pillars of management - derived from adult studies. For those caring for critically unwell children, this review outlines recent paediatric studies, current therapies in the context of available literature and novel emerging approaches.
急性肺损伤(ALI)是危重病儿童的重要病症,会导致整体死亡率和发病率上升。ALI 代表了儿童下呼吸道疾病的严重谱。它是肺炎和败血症等疾病的病理高峰。这些病症引发了宿主反应,导致临床上和放射学上定义明确的肺部综合征,从而增加了其他生理负担。尽管在儿科年龄组中已经很好地描述了 ALI,但它的管理在很大程度上是基于成人研究的。通气支持采用小潮气量、呼气末正压(PEEP)和允许性高碳酸血症,这是基于成人研究的管理支柱。对于那些照顾重病儿童的人来说,这篇综述概述了最近的儿科研究、现有文献背景下的当前治疗方法以及新出现的方法。