Goatly Giles, Guidozzi N, Khan M
Department of Surgery, Imperial College Healthcare NHS Trust, London, UK.
Department of Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
J R Army Med Corps. 2019 Jun;165(3):193-197. doi: 10.1136/jramc-2017-000889. Epub 2018 Mar 29.
Acute respiratory distress syndrome (ARDS) was first described in the 1960s and has become a major area of research due to the mortality and morbidity associated with it. ARDS is currently defined using the Berlin Consensus; however, this is not wholly applicable for trauma-related ARDS.
A systematic review of the literature was undertaken using the Preferred Reporting for Systematic Reviews and Meta Analyses methodology. The Ovid Medline, Web of Science and PubMed online databases were interrogated for papers published between 1 January 1995 and 31 December 2017.
The literature search yielded a total of 64 papers that fulfilled the search criteria.
Despite decades of dedicated research into different treatment modalities, ARDS continues to carry a high burden of mortality. The ARDS definitions laid out in the Berlin consensus are not entirely suited to trauma. While trauma-related ARDS represents a small portion of the available research, the evidence continues to favour low tidal volume ventilation as the benchmark for current practice. Positive end expiratory ventilation and airway pressure release ventilation in trauma cohorts may be beneficial; however, the evidence to date does not show this.
急性呼吸窘迫综合征（ARDS）于20世纪60年代首次被描述，由于其相关的死亡率和发病率，已成为一个主要的研究领域。目前ARDS是根据柏林共识来定义的；然而，这并不完全适用于创伤相关的ARDS。
采用系统评价和Meta分析的首选报告方法对文献进行系统评价。检索了Ovid Medline、科学网和PubMed在线数据库中1995年1月1日至2017年12月31日发表的论文。
文献检索共得到64篇符合检索标准的论文。
尽管数十年来对不同治疗方式进行了专门研究，但ARDS的死亡率仍然很高。柏林共识中规定的ARDS定义并不完全适用于创伤。虽然创伤相关的ARDS在现有研究中占比很小，但证据仍然支持低潮气量通气作为当前实践的基准。在创伤队列中，呼气末正压通气和气道压力释放通气可能有益；然而，迄今为止的证据并未表明这一点。
