Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
J Cardiothorac Vasc Anesth. 2022 Apr;36(4):1188-1195. doi: 10.1053/j.jvca.2021.02.053. Epub 2021 Feb 27.
Acute respiratory distress syndrome (ARDS) is a heterogeneous lung disease responsible for significant morbidity and mortality among critically ill patients, including those infected with severe acute respiratory syndrome coronavirus 2, the virus responsible for coronavirus disease 2019. Despite recent advances in pathophysiology, diagnostics, and therapeutics, ARDS is dangerously underdiagnosed, and supportive lung protective ventilation and prone positioning remain the mainstay interventions. Rescue therapies, including neuromuscular blockade and venovenous extracorporeal membrane oxygenation, remain a key component of clinical practice, although benefits are unclear. Even though coronavirus disease 2019 ARDS has some distinguishing features from traditional ARDS, including delayed onset, hyperinflammatory response, and pulmonary microthrombi, it clinically is similar to traditional ARDS and should be treated with established supportive therapies.
急性呼吸窘迫综合征（ARDS）是一种异质性肺病，可导致重症患者（包括感染严重急性呼吸综合征冠状病毒 2 病毒的患者，该病毒是导致 2019 年冠状病毒病的病原体）发生重大发病率和死亡率。尽管在病理生理学、诊断和治疗方面取得了最近的进展，但 ARDS 的诊断仍然严重不足，支持性肺保护性通气和俯卧位仍是主要的干预措施。包括神经肌肉阻滞剂和静脉-静脉体外膜肺氧合在内的抢救疗法仍然是临床实践的重要组成部分，尽管其益处尚不清楚。尽管 2019 年冠状病毒病相关 ARDS 与传统 ARDS 相比具有一些特征，包括发病延迟、过度炎症反应和肺微血栓，但在临床上与传统 ARDS 相似，应采用既定的支持性治疗。
