DiSilvio Briana, Young Meilin, Gordon Ayla, Malik Khalid, Singh Ashley, Cheema Tariq
Division of Pulmonary Critical Care, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania (Drs DiSilvio, Young, Gordon, Malik, and Cheema); and Nursing, Chatham University, Pittsburgh, Pennsylvania (Dr Singh).
Crit Care Nurs Q. 2019 Oct/Dec;42(4):349-361. doi: 10.1097/CNQ.0000000000000275.
Acute respiratory distress syndrome (ARDS) is a disease associated with both short- and long-term complications. Acute complications include refractory respiratory failure requiring prolonged dependence on mechanical ventilation and the subsequent need for tracheostomy and gastrostomy tubes, protracted immobilization, and lengthy stays in the intensive care unit resulting in delirium, critical illness myopathy, and polyneuropathy, as well as secondary nosocomial infections. Chronic adverse outcomes of ARDS include irreversible changes such as fibrosis, tracheal stenosis from prolonged tracheostomy tube placement, pulmonary function decline, cognitive impairment and memory loss, posttraumatic stress disorder, depression, anxiety, muscle weakness, ambulatory dysfunction, and an overall poor quality of life. The degree of disability in ARDS survivors is heterogeneous and can be evident even years after hospitalization. Although survival rates have improved over the past 4 decades, mortality remains significant with rates reported as high as 40%. Despite advancements in management, the causes of death in ARDS have remained relatively unchanged since the 1980s with sepsis/septic shock and multiorgan failure at the top of the list.
急性呼吸窘迫综合征（ARDS）是一种与短期和长期并发症相关的疾病。急性并发症包括难治性呼吸衰竭，需要长期依赖机械通气，随后需要气管造口术和胃造口管，长期制动，以及在重症监护病房长时间停留导致谵妄、危重病性肌病和多发性神经病，以及继发性医院感染。ARDS的慢性不良后果包括不可逆的变化，如纤维化、长期放置气管造口管导致的气管狭窄、肺功能下降、认知障碍和记忆丧失、创伤后应激障碍、抑郁、焦虑、肌肉无力、行走功能障碍以及总体生活质量差。ARDS幸存者的残疾程度各不相同，甚至在住院数年之后仍可能很明显。尽管在过去40年中生存率有所提高，但死亡率仍然很高，报告的死亡率高达40%。尽管在治疗方面取得了进展，但自20世纪80年代以来，ARDS的死亡原因相对没有变化，败血症/感染性休克和多器官功能衰竭位居前列。
