Zhang Feng, Cao Quan, Zuo Xiangrong
Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China. Corresponding author: Zuo Xiangrong, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Mar;29(3):272-275. doi: 10.3760/cma.j.issn.2095-4352.2017.03.017.
Acute respiratory distress syndrome (ARDS) is a severe respiratory condition that is characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema. Despite the improvement of therapeutic methods, the mortality of ARDS is in the range of 40%-50% all over the world. Some studies have shown that a significant number of patients with ARDS had acute cor pulmonale (ACP), and ACP is independently associated with the mortality of patients with ARDS, which has attracted wide attention in recent years. This paper reviewed recent related studies, summarized the prevalence, pathogenesis and diagnostic approaches of ACP in ARDS, especially echocardiography which was considered as a cornerstone for ACP diagnosis, and elucidated the beneficial effects of right ventricular protective ventilatory strategy and prone-positioning on the pulmonary vasculature and right heart, in order to provide a novel idea for the therapy of ACP in ARDS.
急性呼吸窘迫综合征（ARDS）是一种严重的呼吸系统疾病，其特征为迅速进展的低氧血症伴非心源性肺水肿。尽管治疗方法有所改进，但全球范围内ARDS的死亡率仍在40%-50%之间。一些研究表明，相当数量的ARDS患者发生了急性肺心病（ACP），且ACP与ARDS患者的死亡率独立相关，这一情况近年来受到广泛关注。本文回顾了近期相关研究，总结了ARDS中ACP的患病率、发病机制及诊断方法，尤其强调了被视为ACP诊断基石的超声心动图，并阐明了右心室保护性通气策略和俯卧位对肺血管系统及右心的有益作用，以期为ARDS中ACP的治疗提供新思路。
