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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

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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]. 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]. 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.
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