急性肺损伤与急性呼吸窘迫综合征：病理生理学与治疗
Acute lung injury and the acute respiratory distress syndrome: pathophysiology and treatment.
作者信息
Matuschak George M, Lechner Andrew J
机构信息
Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, USA.
出版信息
Mo Med. 2010 Jul-Aug;107(4):252-8.
Abstract
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) represent a spectrum of acute respiratory failure with diffuse, bilateral lung injury and severe hypoxemia caused by non-cardiogenic pulmonary edema. Failure may be initiated by pulmonary or extrapulmonary insults (e.g., pneumonia, sepsis, trauma, aspiration) that increase alveolar epithelial endothelial permeability, flood alveoli, and reduce lung compliance. The only treatment proven to improve survival is mechanical ventilation using a 'lung protective strategy' with tidal volume =6 mL/kg predicted body weight. Although mortality can exceed 50%, survivors have a good prognosis for recovery of lung function.
摘要
急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是一系列急性呼吸衰竭，其特征为非心源性肺水肿导致的弥漫性双侧肺损伤和严重低氧血症。呼吸衰竭可能由肺部或肺外损伤（如肺炎、脓毒症、创伤、误吸）引发，这些损伤会增加肺泡上皮内皮通透性，使肺泡充满液体，并降低肺顺应性。唯一被证明能提高生存率的治疗方法是采用“肺保护性策略”进行机械通气，潮气量=6 mL/千克预测体重。尽管死亡率可能超过50%，但幸存者肺功能恢复的预后良好。
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