Cawley M J, Skaar D J, Anderson H L, Hanson C W
Department of Pharmacy Practice/Pharmacy Administration, Philadelphia College of Pharmacy and Science, Pennsylvania 19104-4495, USA.
Pharmacotherapy. 1998 Jan-Feb;18(1):140-55.
Acute or adult respiratory distress syndrome (ARDS) contributes to mortality and morbidity in the intensive care environment. Appropriate application of microprocessor-controlled mechanical ventilatory support, pathophysiology of the disease, and new pharmacologic modalities are currently being investigated. Mechanical ventilation is usually begun when respiratory failure is caused by alveolar hypoventilation or hypoxia. Primary choices for this therapy are control-mode ventilation, assist-control ventilation, pressure-control ventilation, intermittent mandatory ventilation, and synchronized intermittent mandatory ventilation with the addition of positive end-expiratory pressure. Patients who deteriorate despite these interventions may require alternative modes of ventilation. Pharmacologic agents in ARDS is important due to the multifactorial pathophysiologic and pharmacodynamic processes that are part of the disease. Clinical studies will continue to determine advantageous agents. Unfortunately, no convincing data exist that any pharmacologic or nonpharmacologic strategy is superior for the support of these patients or results in a better outcome than others.
急性或成人呼吸窘迫综合征（ARDS）在重症监护环境中会导致死亡率和发病率升高。目前正在研究微处理器控制的机械通气支持的适当应用、该疾病的病理生理学以及新的药物治疗方法。当呼吸衰竭由肺泡通气不足或低氧血症引起时，通常会开始机械通气。这种治疗的主要选择包括控制模式通气、辅助控制通气、压力控制通气、间歇强制通气以及同步间歇强制通气，并增加呼气末正压。尽管采取了这些干预措施但病情仍恶化的患者可能需要其他通气模式。由于该疾病所涉及的多因素病理生理和药效学过程，ARDS中的药物治疗很重要。临床研究将继续确定有益的药物。不幸的是，没有令人信服的数据表明任何药物或非药物策略在支持这些患者方面更具优势或能带来比其他策略更好的结果。
