Division of Pulmonary, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, MN, USA
Departments of Medicine and Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
BMJ. 2024 Oct 28;387:e076612. doi: 10.1136/bmj-2023-076612.
The understanding of acute respiratory distress syndrome (ARDS) has evolved greatly since it was first described in a 1967 case series, with several subsequent updates to the definition of the syndrome. Basic science advances and clinical trials have provided insight into the mechanisms of lung injury in ARDS and led to reduced mortality through comprehensive critical care interventions. This review summarizes the current understanding of the epidemiology, pathophysiology, and management of ARDS. Key highlights include a recommended new global definition of ARDS and updated guidelines for managing ARDS on a backbone of established interventions such as low tidal volume ventilation, prone positioning, and a conservative fluid strategy. Future priorities for investigation of ARDS are also highlighted.
急性呼吸窘迫综合征（ARDS）自 1967 年首次在一系列病例中描述以来，人们对其认识有了很大的发展，随后对该综合征的定义进行了几次更新。基础科学的进步和临床试验为 ARDS 中肺损伤的机制提供了深入的了解，并通过全面的重症监护干预降低了死亡率。这篇综述总结了目前对 ARDS 的流行病学、病理生理学和治疗的理解。主要亮点包括推荐了一个新的 ARDS 全球定义，以及更新了基于低潮气量通气、俯卧位和保守液体策略等既定干预措施的 ARDS 管理指南。还强调了未来对 ARDS 进行研究的重点。
