Staudinger Thomas
Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Anaesthesiologie. 2025 Jun 23. doi: 10.1007/s00101-025-01555-0.
Acute respiratory distress syndrome (ARDS) is defined as an acute inflammatory syndrome leading to increased pulmonary capillary leakage and subsequent interstitial and alveolar pulmonary edema. Hypoxia is the predominant symptom. The definition of ARDS comprises acute onset, bilateral patchy infiltration on chest X‑ray and a reduction of the ratio of arterial partial pressure of oxygen (PaO) to the fraction of inspired oxygen (FiO), which also determines the classification into mild (≤ 300), moderate (≤ 200) and severe (≤ 100) ARDS. Treating the underlying cause is the only causal treatment measure. The aim of adjunctive therapy is the maintenance of life or organ functions by ensuring an adequate gas exchange without further damaging the lungs. Adjunctive therapy consists mainly of individually adapted "protective" ventilation treatment and the prone position. In severest ARDS, the use of venovenous extracorporeal membrane oxygenation (VV-ECMO) can improve survival if strict criteria for indications and contraindications are followed.
急性呼吸窘迫综合征（ARDS）被定义为一种急性炎症综合征，可导致肺毛细血管渗漏增加，继而引发间质性和肺泡性肺水肿。缺氧是主要症状。ARDS的定义包括急性起病、胸部X线显示双侧斑片状浸润以及动脉血氧分压（PaO）与吸入氧分数（FiO）之比降低，这也决定了其分为轻度（≤300）、中度（≤200）和重度（≤100）ARDS。治疗潜在病因是唯一的病因治疗措施。辅助治疗的目的是通过确保充分的气体交换来维持生命或器官功能，同时避免进一步损伤肺部。辅助治疗主要包括个体化调整的“保护性”通气治疗和俯卧位。在最严重的ARDS中，如果遵循严格的适应证和禁忌证标准，使用静脉-静脉体外膜肺氧合（VV-ECMO）可提高生存率。
