Impellizzeri Daniela, Bruschetta Giuseppe, Esposito Emanuela, Cuzzocrea Salvatore
University of Messina, Department of Biological and Environmental Sciences , Viale Ferdinando Stagno D'Alcontres n°31 98166 Messina , Italy.
Expert Opin Emerg Drugs. 2015 Mar;20(1):75-89. doi: 10.1517/14728214.2015.1000299. Epub 2015 Jan 6.
Acute respiratory distress syndromes (ARDS) are devastating disorders of overwhelming pulmonary inflammation and hypoxemia, resulting in high morbidity and mortality.
The main pharmacological treatment strategies have focused on the attempted inhibition of excessive inflammation or the manipulation of the resulting physiological derangement causing respiratory failure. Additionally, such interventions may allow reduced occurence mechanical ventilation injury. Despite promising preclinical and small clinical studies, almost all therapies have been shown to be unsuccessful in large-scale randomized controlled trials. The evidence for pharmacological treatment for ARDS is reviewed. Potential future treatments are also presented.
We suggest for future clinical trials addressing prevention and early intervention to attenuate lung injury and progression to respiratory failure.
急性呼吸窘迫综合征(ARDS)是严重的肺部炎症和低氧血症导致的破坏性疾病,发病率和死亡率都很高。
主要的药物治疗策略集中在试图抑制过度炎症或处理由此导致的引起呼吸衰竭的生理紊乱。此外,此类干预措施可能会减少机械通气损伤的发生。尽管临床前研究和小型临床研究前景乐观,但几乎所有疗法在大规模随机对照试验中都被证明是不成功的。本文综述了ARDS药物治疗的证据。还介绍了未来可能的治疗方法。
我们建议未来开展临床试验,以进行预防和早期干预,减轻肺损伤并防止进展为呼吸衰竭。