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探索急性呼吸窘迫综合征管理中的药理学策略:疗效、局限性及未来方向。

Exploring pharmacological strategies in the management of ARDS: Efficacy, limitations, and future directions.

作者信息

Almuntashiri Sultan

机构信息

Department of Clinical Pharmacy, College of Pharmacy, University of Ha'il, Ha'il, Saudi Arabia.

出版信息

J Crit Care Med (Targu Mures). 2025 Jul 31;11(3):208-220. doi: 10.2478/jccm-2025-0030. eCollection 2025 Jul.

DOI:10.2478/jccm-2025-0030
PMID:40765544
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321257/
Abstract

Acute respiratory distress syndrome (ARDS) is a severe inflammatory reaction in the lungs caused by sudden pulmonary and systemic injuries. Clinically, this diverse syndrome is marked by sudden hypoxemic respiratory failure and the presence of bilateral lung infiltrates visible on a chest X-ray. ARDS management remains largely supportive, with a focus on optimizing mechanical ventilation strategies and addressing the underlying causes of lung injury. The current pharmacological approach for ARDS primarily focuses on corticosteroids, neuromuscular blocking agents, and beta-2 agonists, however, none has been definitively proven to be consistently effective in improving clinical outcomes. This review summarizes the latest evidence regarding the effectiveness and limitations of these pharmacological interventions, identifying key areas where further research is needed.

摘要

急性呼吸窘迫综合征(ARDS)是由突发的肺部和全身损伤引起的肺部严重炎症反应。临床上,这种多样的综合征以突发的低氧性呼吸衰竭以及胸部X线可见的双侧肺部浸润为特征。ARDS的治疗在很大程度上仍以支持治疗为主,重点是优化机械通气策略并解决肺损伤的根本原因。目前针对ARDS的药物治疗主要集中在皮质类固醇、神经肌肉阻滞剂和β-2激动剂上,然而,尚无一种药物被明确证明能始终有效地改善临床结局。本综述总结了这些药物干预措施有效性和局限性的最新证据,确定了需要进一步研究的关键领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5921/12321257/a29d5f13ba3f/j_jccm-2025-0030_fig_001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5921/12321257/a29d5f13ba3f/j_jccm-2025-0030_fig_001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5921/12321257/a29d5f13ba3f/j_jccm-2025-0030_fig_001.jpg

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阿曲库铵与顺式阿曲库铵治疗急性呼吸窘迫综合征的比较
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Application of Neuromuscular Blockers in Patients with ARDS in ICU: A Retrospective Study Based on the MIMIC-III Database.神经肌肉阻滞剂在重症监护病房急性呼吸窘迫综合征患者中的应用:基于MIMIC-III数据库的回顾性研究
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