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迅速行动并轻柔通气:急性呼吸窘迫综合征柏林定义的杜塞尔多夫实践解读

Act fast and ventilate soft: the Düsseldorf hands-on translation of the acute respiratory distress syndrome Berlin definition.

作者信息

Luedike Peter, Totzeck Matthias, Meyer Christian, Westenfeld Ralf, Kindgen-Milles Detlef, Kelm Malte, Rassaf Tienush

机构信息

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany.

Division of Anaesthesiology, Medical Faculty Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany.

出版信息

J Crit Care. 2014 Oct;29(5):883.e1-5. doi: 10.1016/j.jcrc.2014.03.024. Epub 2014 Apr 2.

Abstract

Early identification of acute respiratory distress syndrome (ARDS) and forceful implementation of standardized therapy algorithms are the mandatory basis of an effective therapy to improve patient outcome. Recently, a new definition of ARDS was implemented, which simplified the diagnostic criteria for ARDS. Evidence-based therapies are rare, but some cornerstone interventions can be recommended. Lung-protective ventilation with high positive end-expiratory pressure and low tidal volume and early prone positioning in severe cases improve survival rate. We here present an integrated "Düsseldorf hands-on translation" in the form of a "one-page" standard operating procedure in order to fasten and standardize both diagnosis and therapeutic algorithms on an intensive care unit.

摘要

早期识别急性呼吸窘迫综合征(ARDS)并强力实施标准化治疗方案是改善患者预后的有效治疗的必要基础。最近,实施了ARDS的新定义,简化了ARDS的诊断标准。循证治疗很少见,但可以推荐一些基础干预措施。采用高呼气末正压和低潮气量的肺保护性通气以及在严重病例中早期采用俯卧位可提高生存率。我们在此以“单页”标准操作程序的形式呈现一个综合的“杜塞尔多夫实操翻译”,以便在重症监护病房加快并规范诊断和治疗方案。

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