Deb B, Pearl R G
Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Int Anesthesiol Clin. 1997 Winter;35(1):109-24. doi: 10.1097/00004311-199703510-00009.
Acute respiratory distress syndrome is a response of the lung to both direct and indirect insults. Although much knowledge has been gained in understanding the pathophysiology of the syndrome, overall mortality in the past 25 years remains unchanged. Application of scientific knowledge to present-day technology has yielded advances in ventilator and pharmacological support for the patient with ARDS. Emphasis is now made on the prevention of iatrogenic lung injury with the use of pressure-limited mechanical ventilation, permissive hypercapnia, and artificial means of gas exchange (discussed in the chapter by Dr Furukawa). The role of INO and surfactant, as well as antimediator therapy, in the armamentarium against ARDS appears promising but awaits definitive clinical trials. Only with progress and newer therapies will we be able to improve the outlook for patients and families in the future.
急性呼吸窘迫综合征是肺部对直接和间接损伤的一种反应。尽管在理解该综合征的病理生理学方面已取得了很多知识，但在过去25年里其总体死亡率仍未改变。将科学知识应用于当今技术已在为急性呼吸窘迫综合征患者提供通气和药物支持方面取得了进展。现在重点在于通过使用压力限制机械通气、允许性高碳酸血症和人工气体交换手段（在古川医生所写章节中讨论）来预防医源性肺损伤。吸入一氧化氮和表面活性剂以及抗介质治疗在对抗急性呼吸窘迫综合征的手段中所起的作用似乎很有前景，但尚有待确定性的临床试验。只有取得进展并采用更新的治疗方法，我们才能在未来改善患者及其家庭的前景。
