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中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (03): 202 -207. doi: 10.3877/cma.j.issn.2096-1537.2017.03.010

所属专题: 中国重症基层诊疗流程 指南规范 文献资源库

基层诊疗流程 上一篇    下一篇

急性呼吸窘迫综合征有创机械通气治疗流程解析
郑瑞强 1, 翟茜 2, 胡波 3, 张丽娜 4, 虞文魁 5, 杨向红 6, 隆云 7 , ( )   
  1. 1. 225001 扬州,江苏省苏北人民医院重症医学科
    2. 250002 济南,山东大学齐鲁医院重症医学科
    3. 430071 武汉大学中南医院重症医学科
    4. 410013 长沙,中南大学湘雅医院重症医学科
    5. 210002 南京大学医学院附属金陵医院重症医学科
    6. 310006 杭州,浙江省人民医院重症医学科
    7. 100032 北京,中国医学科学院北京协和医院重症医学科
  • 收稿日期:2017-01-16 出版日期:2017-08-28
  • 通信作者: 隆云
  • 基金资助:
    江苏省第五期"333高层次人才培养工程"项目(2016-18); 北京协和医学院2016年度教学质量工程项目(2016zlgc0713)

Analysis of invasive mechanical ventilation protocol in acute respiratory distress syndrome

Ruiqiang Zheng 1, Qian Zhai 2, Bo Hu 3, Lina Zhang 4, Wenkui Yu 5, Xianghong Yang 6, Yun Long 7 , ( )   

  1. 1. Department of Critical Care Medicine, Northern Jiangsu People’s Hospital, Yangzhou 225001, China
    2. Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan 250002, China
    3. Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
    4. Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410013, China
    5. Department of Critical Care Medicine, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing 210002, China
    6. Department of Critical Care Medicine, Zhejiang Provincial People′s Hospital, Hangzhou 310006, China
    7. Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
  • Received:2017-01-16 Published:2017-08-28
  • Corresponding author: Yun Long
  • About author:
    Corresponding author: Long Yun, Email:

有创机械通气是治疗急性呼吸窘迫综合征(ARDS)的重要手段之一。目前,临床对于ARDS的有创机械通气治疗并不十分规范,对此进一步流程化及规范化,有助于临床提高该病治疗成功率,降低其病死率。因此,本研究制定了ARDS有创机械通气治疗的规范化流程,具体包括:建立人工气道和呼吸机初始参数的选择,小潮气量为主的肺保护性通气策略,辅助性治疗,挽救治疗,小潮气量通气治疗后高碳酸血症的处理,以及有创呼吸机的撤离。

Invasive mechanical ventilation is one of the important therapies in acute respiratory distress syndrome (ARDS). At present, the clinical management of invasive mechanical ventilation for ARDS is still not standardized. Standardization of the invasive mechanical ventilation protocol will be helpful to improve the effect of mechanical ventilation and reduce mortality in ARDS. In this study, we performed a standardized protocol of invasive mechanical ventilation in patients with ARDS including the choice of artificial airway and initial ventilator mode, low tidal volume of lung protective strategy, adjunctive and rescue strategies, methods of deal with the hypercapnia after low tidal volume ventilation and weaning from the invasive ventilation.

图1 ARDS有创机械通气治疗流程图
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