急性呼吸障害症候群

Rob Mac Sweeney¹, Daniel F McAuley²

¹Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK.

Lancet (London, England)

|May 3, 2016

まとめ

急性呼吸困難症候群 (ARDS) は,機械呼吸器や液体管理を含むサポートケアを必要とします. 重篤な症例では横たわることやECMOなどの介入が有益である種の薬は避けておくべきです

科学分野:

クリティカルケア医療
肺科
呼吸器医学

背景:

急性呼吸器障害症候群 (ARDS) は,低酸素と双方の肺の浸透によって特徴づけられる重篤な臨床状態である.
心不全が原因でないと診断される.
現在の管理は主にサポートしています.

研究の目的:

ARDSの診断と管理の重要な側面を要約する.
効果的な治療戦略と禁忌を強調する
ARDSの結果の概要を提示する.

主な方法:

ARDSの管理のための現在の臨床ガイドラインと証拠のレビュー.
機械呼吸や水分バランスといったサポートケア戦略に重点を置きます
重度の低酸素症に対する特定の介入の評価

主要な成果:

保護的な機械的な換気と流体過負荷の回避は,ARDS管理の中心です.
早期の短期神経筋阻害,横たわった状態の換気,または体外膜酸素化 (ECMO) は重度の低酸素症の選択肢です.
吸入された酸化窒素,β2アゴニスト,および遅いコルチコステロイドは一般的に示されず,避けるべきです.

結論:

ARDSの治療は主に肺を保護する戦略を強調するものです
重症の場合には特別な治療法がありますが慎重に患者を選択することが重要です
ARDSの死亡率は,約30%にとどまっている.

さらに関連する動画

07:20

Lavage-induced Surfactant Depletion in Pigs As a Model of the Acute Respiratory Distress Syndrome ARDS

Published on: September 7, 2016

11.7K

06:06

Oleic Acid-Injection in Pigs As a Model for Acute Respiratory Distress Syndrome

Published on: October 26, 2018

10.4K

関連する概念動画

01:23

Acute Respiratory Failure-IV

693

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...

693

01:21

Acute Respiratory Failure-I

1.4K

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...

1.4K

01:21

Acute Respiratory Failure-II

1.5K

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:

1.5K

01:30

Acute Respiratory Failure-III

1.1K

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...

1.1K

01:29

Acute Respiratory Failure-V

623

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...

623

01:23

Assessment of Respiration

2.3K

The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...