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中华重症医学电子杂志 ›› 2016, Vol. 02 ›› Issue (04) : 291 -296. doi: 10.3877/cma.j.issn.2096-1537.2016.04.015

所属专题: 文献

综述

急性呼吸窘迫综合征血流动力学管理:聚焦液体管理
孙庆文1, 谢碧芳1, 梁微波1, 徐远达1, 黎毅敏1,()   
  1. 1. 510120 广州,呼吸疾病国家重点实验室,广州医科大学附属第一医院重症医学科
  • 收稿日期:2016-10-31 出版日期:2016-11-28
  • 通信作者: 黎毅敏
  • 基金资助:
    国家自然科学基金重大项目(81490534); 广东省自然科学基金(2015A030313480); 广东省科技计划项目(2016A020215170); 广州市科技计划项目(201400000002和2014Y-00065)

Hemodynamic management in acute respiratory distress syndrome: focus on fluid management

Qingwen Sun1, Bifang Xie1, Weibo Liang1, Yuanda Xu1, Yimin Li1,()   

  1. 1. State Key Lab of Respiratory Disease, The First Affiliated to Guangzhou Medical University, Guangzhou 510120, China
  • Received:2016-10-31 Published:2016-11-28
  • Corresponding author: Yimin Li
  • About author:
    Corresponding author: Li Yimin, Email:
引用本文:

孙庆文, 谢碧芳, 梁微波, 徐远达, 黎毅敏. 急性呼吸窘迫综合征血流动力学管理:聚焦液体管理[J]. 中华重症医学电子杂志, 2016, 02(04): 291-296.

Qingwen Sun, Bifang Xie, Weibo Liang, Yuanda Xu, Yimin Li. Hemodynamic management in acute respiratory distress syndrome: focus on fluid management[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2016, 02(04): 291-296.

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是以肺毛细血管通透性增加为主要临床表现的炎性综合征,超过60%的ARDS患者存在血流动力学障碍,加上正压机械通气的影响,正确评估容量状态、纠正血流动力学紊乱可避免在低氧血症基础上对机体的二次打击,是治疗ARDS的重要组成部分;除了限制性的液体管理策略,需要对合并休克的ARDS患者在不同阶段采取差异化液体管理,除考虑不同类型的ARDS外,还要考虑人机同步、通气模式、肺复张、镇静镇痛以及液体的种类,避免急性肺心病的发生,本文就ARDS的液体管理进展进行综述。

Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized as an increased pulmonary capillary permeability and systemic inflammation. More than 60% of ARDS patients complicated with hemodynamic disorder, which might be worsen during mechanical ventilation. It is important to assess volume status and correct hemodynamic disorder during treatment of ARDS. In addition to restrictive fluid management strategy, an individualized fluid management according to different stage and type of the disease, mechanical ventilaiton setting and synchrony, recruitment maneuver, use of sedatives and analgesics, fluid type we give to the patient, as well as avoiding acute cor pulmonale,is necessary to manage ARDS patients complicated with hemodynamic disorder. This review makes a summary of the advances in fluid management of ARDS patients.

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