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中华重症医学电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 120 -123. doi: 10.3877/cma.j.issn.2096-1537.2020.02.002

所属专题: 重症医学 文献

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急性呼吸窘迫综合征及呼吸支持理念:2019年的反思与进步
潘纯1, 孙骎1, 邱海波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:2020-01-14 出版日期:2020-05-28
  • 通信作者: 刘玲

Acute respiratory distress syndrome and mechanical ventilation concept: rethinking and progress in 2019

Chun Pan1, Qin Sun1, Haibo Qiu1, Ling Liu1,()   

  1. 1. Department of Critical Care Medicine, Zhongda Hospital Southeast University, Nanjing 210009, China
  • Received:2020-01-14 Published:2020-05-28
  • Corresponding author: Ling Liu
  • About author:
    Corresponding anthor: Liu Ling, Email:
引用本文:

潘纯, 孙骎, 邱海波, 刘玲. 急性呼吸窘迫综合征及呼吸支持理念:2019年的反思与进步[J/OL]. 中华重症医学电子杂志, 2020, 06(02): 120-123.

Chun Pan, Qin Sun, Haibo Qiu, Ling Liu. Acute respiratory distress syndrome and mechanical ventilation concept: rethinking and progress in 2019[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(02): 120-123.

急性呼吸窘迫综合征(ARDS)是临床常见的危重症,目前针对肺保护性通气及避免肺损伤的呼吸支持策略的优化仍未对ARDS患者预后产生实质的改善。2019年ARDS的诊断和治疗理念仍在不断的更新,主要包括对"肺开放"和"肺休息"以及神经肌肉阻滞剂应用的反思、发生ARDS预测指标、机械功与ARDS患者预后及脱机模式对脱机预后的影响等。目前的进展表明ARDS临床特征及治疗反应的异质性仍被忽略,结合信息技术及大数据分析的发展,推动实现ARDS精准化治疗是未来的方向。

Acute respiratory distress syndrome (ARDS) is a clinically common critical illness. However, optimization of respiratory support strategies for protective lung ventilation and avoiding lung injury has not yet resulted in a substantial improvement in the prognosis of ARDS patients. The concepts of diagnosis and treatment of ARDS have been updated in 2019, which include "open lung strategy" and "close lung strategy ", application of neuromuscular blockers, predictors of occurrence of ARDS, mechanical power, prognosis of patients with ARDS, and the impact of ventilation mode on weaning prognosis. The current progress indicates that the clinical characteristics and the heterogeneity of treatment response of ARDS are still being ignored. Combining the development of information technology and big data analysis could promote the precise treatment of ARDS in the future.

1
Liu L, Yang Y, Gao Z, et al. Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study[J]. J Thorac Dis, 2018, 10(9): 5394-5404.
2
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.
3
Lachmann B. Open the lung and keep the lung open[J]. Intensive Care Med, 1992, 18(6): 319-21.
4
Goligher EC, Hodgson CL, Adhikari NKJ, et al. Lung recruitment maneuvers for adult patients with acute respiratory distress syndrome. A systematic review and meta-analysis[J]. Annals of the American Thoracic Society, 2017, 14(Supplement_4): S304-S11.
5
Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial I, Cavalcanti AB, Suzumura EA, et al. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: A Randomized Clinical Trial[J]. JAMA, 2017, 318(14): 1335-1345.
6
Cressoni M, Chiumello D, Algieri L, et al. Opening pressures and atelectrauma in acute respiratory distress syndrome[J]. Intensive Care Med, 2017, 43(5):603-611.
7
Tsuchida S, Engelberts D, Peltekova V, et al. Atelectasis causes alveolar injury in nonatelectatic lung regions[J]. Am J Respir Crit Care Med, 2006, 174(3): 279-289.
8
Chu EK, Whitehead T, Slutsky AS. Effects of cyclic opening and closing at low- and high-volume ventilation on bronchoalveolar lavage cytokines[J]. Crit Care Med, 2004, 32(1): 168-174.
9
Guldner A, Braune A, Ball L, et al. Comparative effects of volutrauma and atelectrauma on lung inflammation in experimental acute respiratory distress syndrome[J]. Crit Care Med, 2016, 44(9): e854-865.
10
Malbrain M, Pelosi P. Open up and keep the lymphatics open: they are the hydraulics of the body![J]. Crit Care Med, 2006, 34(11): 2860-2862.
11
Repesse X, Charron C, Vieillard-Baron A. Acute cor pulmonale in ARDS: rationale for protecting the right ventricle[J]. Chest, 2015, 147(1): 259-265
12
Yoshida T, Fujino Y, Amato MB, et al. Fifty Years of research in ARDS. spontaneous breathing during mechanical ventilation. Risks, mechanisms, and management[J]. Am J Respir Crit Care Med, 2017, 195(8): 985-992.
13
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.
14
National Heart L, Blood Institute PCTN, Moss M, et al. Early neuromuscular blockade in the acute respiratory distress syndrome[J]. N Engl J Med, 2019, 380: 1997-2008.
15
Morais CCA, Koyama Y, Yoshida T, et al. High positive end-expiratory pressure renders spontaneous effort non-injurious[J]. Am J Respir Crit Care Med, 2018, 197(10): 1285-1296.
16
Faust HE, Reilly, P, Anderson BJ, et al. Plasma mitochondrial DNA levels are associated with acute respiratory distress syndrome in trauma and sepsis patients[J]. Chest, 2019,

URL    
17
Serpa Neto A, Deliberato RO, Johnson AEW, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts[J]. Intensive Care Med, 2018, 44(11): 1914-1922.
18
Zhang Z, Zheng B, Liu N, et al. Mechanical power normalized to predicted body weight as a predictor of mortality in patients with acute respiratory distress syndrome[J]. Intensive Care Med, 2019, 45(6): 856-864.
19
Parhar KKS, Zjadewicz K, Soo A, et al. Epidemiology, mechanical power, and 3-year outcomes in acute respiratory distress syndrome patients using standardized screening. An observational cohort study[J]. Ann Am Thorac Soc, 2019, 16(10): 1263-1272.
20
Schmidt GA, Girard TD, Kress JP, et al. Official executive summary of an american thoracic society/American college of chest physicians clinical practice guideline: Liberation from mechanical ventilation in critically ill adults[J]. Am J Respir Crit Care Med, 2017, 195(1): 115-119.
21
Subirà C, Hernández G, Vázquez A, et al. Effect of pressure support vs T-piece ventilation strategies during spontaneous breathing trials on successful extubation among patients receiving mechanical ventilation: A randomized clinical trial[J]. JAMA, 2019, 321(22): 2175-2182.
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