Festic Emir, Kor Daryl J, Gajic Ognjen
aPulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida bAnesthesiology and Critical Care Medicine cPulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Curr Opin Crit Care. 2015 Feb;21(1):82-90. doi: 10.1097/MCC.0000000000000174.
The paucity of effective therapeutic interventions in patients with the acute respiratory distress syndrome (ARDS) combined with overwhelming evidence on the importance of timely implementation of effective therapies to critically ill patients has resulted in a recent shift in ARDS research. Increasingly, efforts are being directed toward early identification of patients at risk with a goal of prevention and early treatment, prior to development of the fully established syndrome. The focus of the present review is on the prevention of ARDS in patients without this condition at the time of their healthcare encounter.
The primary thematic categories presented in the present review article include early identification of patients at risk of developing ARDS, optimization of care delivery and its impact on the incidence of ARDS, pharmacological prevention of ARDS, prevention of postoperative ARDS, and challenges and opportunities with ARDS prevention studies.
Recent improvements in clinical care delivery have been associated with a decrease in the incidence of hospital-acquired ARDS. Despite the initial challenges, research in ARDS prevention has become increasingly feasible with several randomized controlled trials on ARDS prevention completed or on the way.
急性呼吸窘迫综合征（ARDS）患者有效的治疗干预措施匮乏，加之有大量证据表明对危重症患者及时实施有效治疗非常重要，这导致近期ARDS研究出现了转变。越来越多的努力旨在早期识别有风险的患者，目标是在完全发展成该综合征之前进行预防和早期治疗。本综述的重点是在医疗接触时没有这种病症的患者中预防ARDS。
本综述文章中呈现的主要主题类别包括早期识别有发生ARDS风险的患者、优化护理提供及其对ARDS发病率的影响、ARDS的药物预防、术后ARDS的预防以及ARDS预防研究的挑战与机遇。
临床护理提供方面最近的改善与医院获得性ARDS发病率的降低有关。尽管最初存在挑战，但随着几项关于ARDS预防的随机对照试验已经完成或正在进行，ARDS预防研究已变得越来越可行。
