Hendrickson Kathryn W, Peltan Ithan D, Brown Samuel M
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Utah School of Medicine, 26 North 1900 East, Salt Lake City, UT 84112, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Utah School of Medicine, 26 North 1900 East, Salt Lake City, UT 84112, USA; Pulmonary Division, Department of Medicine, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84107, USA.
Crit Care Clin. 2021 Oct;37(4):703-716. doi: 10.1016/j.ccc.2021.05.001.
Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome of high morbidity and mortality with global impact. Current epidemiologic estimates are imprecise given differences in patient populations, risk factors, resources, and practice styles around the world. Despite improvement in supportive care which has improved mortality, effective targeted therapies remain elusive. The Coronavirus Disease 2019 pandemic has resulted in a large number of ARDS cases that, despite less heterogeneity than multietiologic ARDS populations, still exhibit wide variation in physiology and outcomes. Intensive care unit rates of death have varied widely in studies to date because of a variety of patient and hospital-level factors. Despite some controversy, the best management of these patients is likely the same supportive measures shown to be effective in classical ARDS. Further epidemiologic studies are needed to help characterize the epidemiology of ARDS subphenotypes to facilitate identification of targeted therapies.
急性呼吸窘迫综合征（ARDS）是一种发病率和死亡率均较高的异质性综合征，具有全球影响。鉴于世界各地患者群体、风险因素、资源和医疗实践方式存在差异，目前的流行病学估计并不精确。尽管支持性治疗有所改善，死亡率有所降低，但有效的靶向治疗方法仍然难以捉摸。2019年冠状病毒病大流行导致了大量ARDS病例，尽管与多病因ARDS患者群体相比异质性较小，但生理状况和治疗结果仍存在很大差异。由于多种患者和医院层面的因素，迄今为止的研究中重症监护病房的死亡率差异很大。尽管存在一些争议，但对这些患者的最佳管理可能仍是那些已被证明对经典ARDS有效的支持性措施。需要进一步开展流行病学研究，以帮助描述ARDS亚表型的流行病学特征，从而便于确定靶向治疗方法。
