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急性呼吸窘迫综合征肺保护进展

Progress of lung protection in acute respiratory distress syndrome

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急性呼吸窘迫综合征(ARDS)概念的提出已有 50 余年,其实验和临床研究有了显著的进步,然而病死率仍无明显改善."肺保护"策略已成为ARDS治疗的基石,小潮气量通气、神经肌肉阻滞剂应用、俯卧位实施、体外膜肺氧合技术构成其核心内涵,具有里程碑意义.随着对ARDS病理生理认知的深入,肺-膈肌保护通气日益引起关注.新型冠状病毒的肺炎的流行,使我们对这些经典治疗又有了新的理解.
The concept of acute respiratory distress syndrome(ARDS)has been proposed for more than 50 years,and significant progress has been made in experimental and clinical research.However,the mortality rate has not significantly improved."Lung protection"strategy has become the cornerstone of ARDS treatment.Low tidal volume ventilation,application of neuromuscular blockers,prone position implementation,and extracorporeal membrane oxygenation technology constitute its core connotation,which is a milestone.With the deepening understanding of the pathophysiology of ARDS,lung-diaphragm protective ventilation is increasingly attracting attention.The prevalence of coronavirus disease 2019 has given us a new understanding of these classic treatments.

Acute respiratory distress syndromeVentilator induced lung injuryLung protective ventilationDiaphragm dysfunction

瞿海龙、张冰、王利丽、张红强

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河北大学附属医院急诊医学科,河北 保定 071000

急性呼吸窘迫综合征 呼吸机相关肺损伤 肺保护性通气 膈肌功能障碍

2024

中国急救复苏与灾害医学杂志
中国医学救援学会

中国急救复苏与灾害医学杂志

CSTPCD
影响因子:0.568
ISSN:1673-6966
年,卷(期):2024.19(12)