Braune S, Kluge S
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Dtsch Med Wochenschr. 2013 May;138(19):1019-22. doi: 10.1055/s-0032-1333051. Epub 2013 Apr 30.
The acute respiratory distress syndrome (ARDS) is characterized by severe impairment of gas exchange and remains a challenge for modern intensive care medicine. The most common causes of ARDS are pneumonia and sepsis. The mortality in severe ARDS is as high as 50 %. The new definition of ARDS differentiates three levels of severity depending on the degree of hypoxaemia. The fundamental basis of therapy is to treat the underlying cause of ARDS. Furthermore, lung protective mechanical ventilation must be applied using low tidal volumes and limiting inspiratory pressures. Intermittent prone positioning can reduce mortality in severe cases of ARDS. In extreme, life threatening cases extracorporeal membrane oxygenation can stabilize gas exchange and serve as a bridge to recovery and means to enable lung protective ventilation.
急性呼吸窘迫综合征（ARDS）的特征是气体交换严重受损，仍然是现代重症医学面临的一项挑战。ARDS最常见的病因是肺炎和脓毒症。重度ARDS的死亡率高达50%。ARDS的新定义根据低氧血症程度区分出三个严重程度级别。治疗的根本基础是治疗ARDS的潜在病因。此外，必须采用低潮气量并限制吸气压力来进行肺保护性机械通气。对于严重的ARDS病例，间歇性俯卧位可降低死亡率。在极端的、危及生命的情况下，体外膜肺氧合可稳定气体交换，并作为恢复的桥梁以及实现肺保护性通气的手段。
