重症急性呼吸窘迫综合征的优化策略
Optimal Strategies for Severe Acute Respiratory Distress Syndrome.
作者信息
Cannon Jeremy W, Gutsche Jacob T, Brodie Daniel
机构信息
Division of Trauma, Surgical Critical Care & Emergency Surgery, The Perelman School of Medicine at the University of Pennsylvania, 51 North 39th Street, MOB Suite 120, Philadelphia, PA 19104, USA.
Department of Anesthesiology and Critical Care, The Perelman School of Medicine at the University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA.
出版信息
Crit Care Clin. 2017 Apr;33(2):259-275. doi: 10.1016/j.ccc.2016.12.010.
Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation. Alternative ventilator strategies include high-frequency ventilation and airway pressure release ventilation. This article reviews these options in patients with severe ARDS.
急性呼吸窘迫综合征（ARDS）在重症监护病房收治患者中占比超过10%，在接受机械通气的患者中占近25%。死亡率仍高达40%，且对于存活患者而言，恢复过程会持续数月甚至数年。早期识别并尽量减少进一步的肺损伤对于严重ARDS的成功治疗至关重要。作为肺保护性通气补充的高级治疗策略包括短期神经肌肉阻滞、俯卧位通气和体外膜肺氧合。其他通气策略包括高频通气和气道压力释放通气。本文综述了重症ARDS患者的这些治疗选择。
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