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 ›› 2019, Vol. 05 ›› Issue (02) : 96 -98. doi: 10.3877/cma.j.issn.2096-1537.2019.02.003

所属专题: 重症医学 总编推荐 文献

述评

2018年:急性呼吸窘迫综合征与呼吸支持理念的进步
潘纯1, 孙骎1, 刘玲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:2019-03-26 出版日期:2019-05-28
  • 通信作者: 刘玲
  • 基金资助:
    国家自然科学基金(81670074,81870066); 江苏省自然科学基金(BK20181271); 江苏省医学重点学科项目(ZDXKA2016025); 江苏省青年医学人才项目(QNRC2016807); 江苏省第五期"333高层次人才培养工程"第三层次人才项目(LGY2016251)

2018: concept of ARDS and mechanical ventilation

Chun Pan1, Qin Sun1, Ling Liu1,()   

  1. 1. Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2019-03-26 Published:2019-05-28
  • Corresponding author: Ling Liu
  • About author:
    Corresponding author: Liu Ling, Email:
引用本文:

潘纯, 孙骎, 刘玲. 2018年:急性呼吸窘迫综合征与呼吸支持理念的进步[J/OL]. 中华重症医学电子杂志, 2019, 05(02): 96-98.

Chun Pan, Qin Sun, Ling Liu. 2018: concept of ARDS and mechanical ventilation[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(02): 96-98.

急性呼吸窘迫综合征(ARDS)是严重威胁人类健康的危重症,如何合理呼吸支持治疗避免呼吸机相关肺损伤仍是ARDS治疗面临的难题。2018年ARDS的诊治及呼吸支持理念仍在不断更新,ARDS的再分层和对治疗反应的再思考使得其治疗更为精准;肺保护性通气理念的进展让临床医师更为关注驱动压和膈肌功能的保护,然而,高流量氧疗并未能改善免疫抑制的呼吸衰竭患者的预后。今后基于病理生理和治疗反应性的研究会让我们能够更为精准地选择治疗措施进而改善患者的临床预后。

Acute respiratory distress syndrome (ARDS) is a disastrous disease which badly threats people′s health. It is still a difficult problem how to properly set ventilation support and avoid ventilator-related lung injury. In 2018, the concept of ARDS and the theory of respiratory support were updated. The re-stratification of ARDS and the rethinking of treatment response make the treatment for ARDS more precise. Lung protection ventilation is more about driving pressure and diaphragm function protection, and high flow nasal cannular failed improving the prognosis of immunosuppressed patients with respiratory failure. In the future, research based on pathophysiology and therapeutic responsiveness will allow us to more precisely select treatments to improve the patients′ outcomes.

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
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.
3
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.
4
Maiolo G, Collino F, Vasques F, et al. Reclassifying acute respiratory distress syndrome [J]. Am J Respir Crit Care Med, 2018, 197(12):1586-1595.
5
Madotto F, Pham T, Bellani G, et al. Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study [J]. Intensive Care Med, 2018, 44(5):564-577.
6
Bos LD, Schouten LR, van Vught LA, et al. Identification and validation of distinct biological phenotypes in patients with acute respiratory distress syndrome by cluster analysis [J]. Thorax, 2017, 72(10):876-883.
7
Famous KR, Delucchi K, Ware LB, et al. Acute respiratory distress syndrome subphenotypes respond differently to randomized fluid management strategy [J]. Am J Respir Crit Care Med, 2017, 195(3):331-338.
8
Calfee CS, Delucchi KL, Sinha P, et al. Acute respiratory distress syndrome subphenotypes and differential response to simvastatin: secondary analysis of a randomised controlled trial [J]. Lancet Respir Med, 2018, 6(9):691-698.
9
Gattinoni L, Carlesso E, Caironi P. Stress and strain within the lung [J]. Curr Opin Crit Care, 2012, 18(1):42-47.
10
Villar J, Martin-Rodriguez C, Dominguez-Berrot AM, et al. A quantile analysis of plateau and driving pressures: effects on mortality in patients with acute respiratory distress syndrome receiving lung-protective ventilation [J]. Crit Care Med, 2017, 45(5):843-850.
11
De Jong A, Cossic J, Verzilli D, et al. Impact of the driving pressure on mortality in obese and non-obese ARDS patients: a retrospective study of 362 cases [J]. Intensive Care Med, 2018, 44(7):1106-1114.
12
Schmidt MFS, Amaral A, Fan E, et al. Driving pressure and hospital mortality in patients without ARDS: a cohort study [J]. Chest, 2018, 153(1):46-54.
13
Blondonnet R, Joubert E, Godet T, et al. Driving pressure and acute respiratory distress syndrome in critically ill patients [J]. Respirology, 2019, 24(2):137-145.
14
Toufen Junior C, De Santis Santiago RR, Hirota AS, et al. Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome [J]. Ann Intensive Care, 2018, 8(1):119.
15
Goligher EC, Dres M, Fan E, et al. Mechanical ventilation-induced diaphragm atrophy strongly impacts clinical outcomes [J]. Am J Respir Crit Care Med, 2018, 197(2):204-213.
16
Schepens T, Dres M, Heunks L, et al. Diaphragm-protective mechanical ventilation [J]. Curr Opin Crit Care, 2019, 25(1):77-85.
17
Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure [J]. N Engl J Med, 2015, 372(23):2185-2196.
18
Azoulay E, Lemiale V, Mokart D, et al. Effect of high-flow nasal oxygen vs standard oxygen on, 28-day mortality in immunocompromised patients with acute respiratory failure: the HIGH randomized clinical trial [J]. JAMA, 2018, 320(20):2099-2107.
[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] 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.
[5] 张璇, 高杨, 房雅君, 姚艳玲. 保护性机械通气在肺癌胸腔镜肺段切除术中的临床应用[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 563-567.
[6] 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.
[7] 潘清, 葛慧青. 基于机械通气波形大数据的人机不同步自动监测方法[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 399-403.
[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] 苗明月, 周建新. 肺保护性镇静:应重视呼吸驱动和吸气努力的床旁评估[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 325-328.
[10] 韦小霞, 陈管洁, 李雪珠, 李晓青, 钱淑媛. 机械通气患者抗菌药物雾化吸入的临床实施[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 334-337.
[11] 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.
[12] 刘春峰, 徐朝晖, 施红伟, 陈瑢, 马腾飞, 李鹏飞, 袁蓉, 陈建荣, 徐爱明. 机械通气患者肌肉减少症的诊断及其对预后的影响[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 820-825.
[13] 王文珠, 刘建, 袁常秀, 石亚飞, 尤培军. 竖脊肌平面阻滞对非体外循环冠状动脉旁路移植术中阿片类药物用量的影响[J/OL]. 中华诊断学电子杂志, 2024, 12(03): 155-159.
[14] 刘晓鹏, 柳聪艳, 杨宁, 蔡琛, 李晓兵, 王红宇, 张思森. 三穴五针联合腹部提压法在机械通气患者肺康复中的疗效[J/OL]. 中华卫生应急电子杂志, 2024, 10(04): 193-198.
[15] 刘晴雯, 韩勇, 陈丽丹, 邓哲. 早期机械通气对成人院内心脏骤停病死率的影响:一项回顾性队列研究[J/OL]. 中华卫生应急电子杂志, 2024, 10(04): 203-206.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?