Division of Pulmonary Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
Am J Med Sci. 2021 Jul;362(1):13-23. doi: 10.1016/j.amjms.2020.12.019. Epub 2020 Dec 26.
Acute respiratory distress syndrome (ARDS) is a clinically and biologically heterogeneous disorder associated with a variety of disease processes that lead to acute lung injury with increased non-hydrostatic extravascular lung water, reduced compliance, and severe hypoxemia. Despite significant advances, mortality associated with this syndrome remains high. Mechanical ventilation remains the most important aspect of managing patients with ARDS. An in-depth knowledge of lung protective ventilation, optimal PEEP strategies, modes of ventilation and recruitment maneuvers are essential for ventilatory management of ARDS. Although, the management of ARDS is constantly evolving as new studies are published and guidelines being updated; we present a detailed review of the literature including the most up-to-date studies and guidelines in the management of ARDS. We believe this review is particularly helpful in the current times where more than half of the acute care hospitals lack in-house intensivists and the burden of ARDS is at large.
急性呼吸窘迫综合征（ARDS）是一种临床表现和生物学特征均存在异质性的疾病，与多种疾病过程相关，这些疾病可导致以非静态性肺血管外液增加、顺应性降低和严重低氧血症为特征的急性肺损伤。尽管取得了显著进展，该综合征相关死亡率仍然居高不下。机械通气仍然是管理 ARDS 患者最重要的方面。深入了解肺保护性通气、最佳呼气末正压（PEEP）策略、通气模式和复张手法，对于 ARDS 的通气管理至关重要。尽管随着新研究的发表和指南的更新，ARDS 的管理不断发展，但我们仍对文献进行了详细回顾，包括 ARDS 管理方面的最新研究和指南。我们认为，在当前情况下，这篇综述特别有帮助，因为超过一半的急性护理医院缺乏内部重症监护医生，而 ARDS 的负担也很大。
