切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (03) : 161 -165. doi: 10.3877/cma.j.issn.2096-1537.2017.03.001

所属专题: 重症医学 总编推荐 文献

述评

病理生理学的进步改变急性呼吸窘迫综合征的治疗策略
潘纯1, 邱海波1,()   
  1. 1. 210009 南京,东南大学附属中大医院重症医学科
  • 收稿日期:2017-01-09 出版日期:2017-08-28
  • 通信作者: 邱海波
  • 基金资助:
    国家自然科学基金(81300043、81571874); 江苏省医学重点学科基金(2017)

Optimization of acute respiratory distress syndrome therapy strategies with advances of pathophysiology

Chun Pan1, Haibo Qiu1,()   

  1. 1. Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2017-01-09 Published:2017-08-28
  • Corresponding author: Haibo Qiu
  • About author:
    Corresponding author: Qiu Haibo, Email:
引用本文:

潘纯, 邱海波. 病理生理学的进步改变急性呼吸窘迫综合征的治疗策略[J/OL]. 中华重症医学电子杂志, 2017, 03(03): 161-165.

Chun Pan, Haibo Qiu. Optimization of acute respiratory distress syndrome therapy strategies with advances of pathophysiology[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(03): 161-165.

急性呼吸窘迫综合征(ARDS)是临床常见的呼吸衰竭,其病理生理学特征为肺容积明显减少,肺顺应性降低和肺通气血流比例失调。随着对ARDS病理生理认识不断进步,临床医师能采取更多的手段和措施对ARDS的肺不均一性进行监测,并对ARDS呼吸功能进行精准的评估和支持。因此,病理生理学的进步在逐渐改变目前人们对ARDS疾病发生发展的认识,并为ARDS的精准治疗提供了理论依据。

Acute respiratory distress syndrome (ARDS) is a common clinical respiratory failure with pathophysiological characteristics including reduced lung volume, decreased lung compliance and imbalanced pulmonary ventilation and perfusion. With the development of understanding in the pathophysiology of ARDS, clinicians have more and more methods to monitor lung heterogeneity and precisely assess and support the ARDS respiratory function. Therefore, the advances of pathophysiology are gradually changing the current understanding of ARDS, and provide the theoretical basis of ARDS precise treatment.

1
Bellani G, Laffey JG, Pham T, et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries[J]. JAMA, 2016, 315(8): 788-800.
2
Sweeney RM, McAuley DF. Acute respiratory distress syndrome[J]. Lancet, 2016, 388(10058): 2416-2430.
3
Bellani G, Mauri T, Pesenti A. Imaging in acute lung injury and acute respiratory distress syndrome[J]. Curr Opin Crit Care, 2012, 18(1): 29-34.
4
Protti A, Andreis DT, Milesi M, et al. Lung anatomy, energy load, and ventilator-induced lung injury[J]. Intensive Care Med Exp, 2015, 3(1): 34.
5
Bellani G, Amigoni M, Pesenti A. Positron emission tomography in ARDS: a new look at an old syndrome[J]. Minerva Anestesiol, 2011, 77(4): 439-447.
6
Liu S, Tan L, Möller K, et al. Identification of regional overdistension, recruitment and cyclic alveolar collapse with electrical impedance tomography in an experimental ARDS model[J]. Crit Care, 2016, 20(1): 119.
7
Schreiter D, Carvalho NC, Katscher S, et al. Experimental blunt chest trauma--cardiorespiratory effects of different mechanical ventilation strategies with high positive end-expiratory pressure: a randomized controlled study[J]. BMC Anesthesiol, 2016, 16: 3.
8
Guerin C, Gattinoni L. Assessment of oxygenation response to prone position ventilation in ARDS by lung ultrasonography[J]. Intensive Care Med, 2016, 42(10): 1601-1603.
9
Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment[J]. Am J Respir Crit Care Med, 2011, 183(3): 341-347.
10
Gattinoni L, Quintel M. Fifty Years of Research in ARDS Why Is Acute Respiratory Distress Syndrome So Important for Critical Care? [J]. Am J Respir Crit Care Med, 2016, 194(9): 1051-1052.
11
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network[J]. N Engl J Med, 2000, 342(18): 1301-1308.
12
Talmor D, Sarge T, Malhotra A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury[J]. N Engl J Med, 2008, 359(20): 2095-2104.
13
Grasso S, Terragni P, Birocco A, et al. ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure[J]. Intensive Care Med, 2012, 38(3): 395-403.
14
Protti A, Votta E, Gattinoni L. Which is the most important strain in the pathogenesis of ventilator-induced lung injury: dynamic or static? [J]. Curr Opin Crit Care, 2014, 20(1): 33-38.
15
Gattinoni L, Tonetti T, Cressoni M, et al. Ventilator-related causes of lung injury: the mechanical power[J]. Intensive Care Med, 2016, 42(10): 1567-1575.
16
Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome[J]. N Engl J Med, 2015, 372(8): 747-755.
17
Pellegrini M, Hedenstierna G, et al. The Diaphragm Acts as a Brake During Expiration to Prevent Lung Collapse[J]. Am J Respir Crit Care Med, 2016, 6. [Epub ahead of print]
18
Yoshida T, Fujino Y, Amato MB, et al. Fifty Years of Research in ARDS. Spontaneous Breathing During Mechanical Ventilation - Risks, Mechanisms & Management[J]. Am J Respir Crit Care Med, 2016, 27.
19
Papazian L, Forel JM, Gacouin A, et al. Neuromuscular blockers in early acute respiratory distress syndrome[J]. N Engl J Med, 2010, 363(12): 1107-1116.
20
Bellani G, Laffey JG, Pham T, et al. Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study[J]. Am J Respir Crit Care Med, 2017, 195(1): 67-77.
21
Guervilly C, Bisbal M, Forel JM, et al. Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome[J]. Intensive Care Med, 2016, 24.
22
Gattinoni L, Caironi P, Cressoni M, et al. Lung recruitment in patients with the acute respiratory distress syndrome[J]. N Engl J Med, 2006, 354(17): 1775-1786.
23
Caironi P, Cressoni M, Chiumello D, et al. Lung opening and closing during ventilation of acute respiratory distress syndrome[J]. Am J Respir Crit Care Med, 2010, 181(6): 578-586.
24
Chiumello D, Marino A, Brioni M, et al. Lung Recruitment Assessed by Respiratory Mechanics and Computed Tomography in Patients with Acute Respiratory Distress Syndrome. What Is the Relationship? [J]. Am J Respir Crit Care Med, 2016, 193(11): 1254-1263.
25
Kacmarek RM, Villar J, Sulemanji D, et al. Open Lung Approach for the Acute Respiratory Distress Syndrome: A Pilot, Randomized Controlled Trial[J]. Crit Care Med, 2016, 44(1): 32-42.
26
Baedorf Kassis E, Loring SH, Talmor D. Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS[J]. Intensive Care Med, 2016, 42(8): 1206-1213.
27
Slutsky AS, Ranieri VM. Ventilator-induced lung injury[J]. N Engl J Med, 2014, 370(10): 980.
28
Langer T, Vecchi V, Belenkiy SM, et al. Extracorporeal gas exchange and spontaneous breathing for the treatment of acute respiratory distress syndrome: an alternative to mechanical ventilation? [J]. Crit Care Med, 2014, 42(3): e211-e220.
29
Hoeper MM, Wiesner O, Hadem J, et al. Extracorporeal membrane oxygenation instead of invasive mechanical ventilation in patients with acute respiratory distress syndrome[J]. Intensive Care Med, 2013, 39(11): 2056-2057.
30
Panwar R, Hardie M, Bellomo R, et al. Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial[J]. Am J Respir Crit Care Med, 2016, 193(1): 43-51.
31
Guérin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome[J]. N Engl J Med, 2013, 368(23): 2159-2168.
[1] 江雅婷, 刘林峰, 沈辰曦, 陈奔, 刘婷, 龚裕强. 组织相关巨噬素3 保护肺血管内皮糖萼治疗急性呼吸窘迫综合征的机制研究[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 353-362.
[2] 李振翮, 魏长青, 甄国栋, 李振富. 脓毒症并发急性呼吸窘迫综合征患者血清S1P、Wnt5a变化及其临床意义[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 293-300.
[3] 杨茂宪, 沈鹏, 王倩倩, 吴旺, 沈永帅, 蒋禛, 徐龙生, 朱建刚, 刘倍倍. 吡啶甲酸镁联合地塞米松对急性呼吸窘迫综合征大鼠的治疗作用研究[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(03): 196-203.
[4] 伍先权, 张立果, 周璇, 梁建深. 乳腺包裹性乳头状癌的临床病理与手术策略联系[J/OL]. 中华普通外科学文献(电子版), 2024, 18(04): 294-297.
[5] 高一飞, 刘根祥, 孙长华, 周广军. 喉返神经监测在无充气腋窝入路腔镜单侧甲状腺切除+中央区淋巴结清扫术中的应用效果[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 483-486.
[6] 李智, 冯芸. NF-κB 与MAPK 信号通路及其潜在治疗靶点在急性呼吸窘迫综合征中的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 840-843.
[7] 王晓霞, 乌丹, 张江英, 乌雅罕, 郝颖楠, 斯日古楞. 《2023 年美国胸科学会关于成人急性呼吸窘迫综合征患者管理的临床实践指南更新》解读[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 338-343.
[8] 杨东星, 沈鹏, 赵慧颖. 免疫球蛋白联合依库珠单抗治疗GBS 并发重度ARDS 患者一例[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 404-408.
[9] 倪韫晖, 杨毅, 袁雪燕, 邱海波. 胸壁加压在急性呼吸窘迫综合征中的应用和临床进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 243-247.
[10] 杨永红, 杨莹, 齐红蕾, 刘福瑞, 朱金源. 单细胞测序在急性呼吸窘迫综合征中的应用进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 248-252.
[11] 李松栗, 黄蔚, 巢杰, 杨毅, 邱海波. 单核/巨噬细胞来源的细胞外囊泡在急性呼吸窘迫综合征中的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 253-257.
[12] 王曦娅, 尹弘青, 丁伟, 徐滨, 于海源, 马东升, 邵军. 桥本背景下甲状腺乳头状癌多参数分析预测大容量淋巴结转移[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 548-554.
[13] 鲁珊, 姚蕴珊, 廖色坭, 陈子恩, 张一剑, 蓝健皓, 魏薇, 刘艳杨, 陈艳红, 陈敦金. 妊娠合并急性阑尾炎100例临床研究[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 214-219.
[14] 俞慧慧, 尹宗智. 妊娠期胃穿孔[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 209-213.
[15] 曹磊, 邵轶普, 张志中, 王晨潮, 孙开文, 董阳, 闫东明, 李红伟, 杨波. 基于遗传基因的烟雾病与烟雾综合征生物信息学分析机制研究[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 350-356.
阅读次数
全文


摘要