急性呼吸困难综合征
Rob Mac Sweeney1, Daniel F McAuley2
1Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
Lancet (London, England)
|May 3, 2016
概括
急性呼吸困难综合征 (ARDS) 需要支持性护理,包括机械通风和流体管理. 严重的病例可能受益于倾斜定位或ECMO等干预措施,同时应避免使用某些药物.
科学领域:
- 危急护理医学
- 肺病学
- 呼吸系统医学
背景情况:
- 急性呼吸困难综合征 (ARDS) 是一种严重的临床疾病,其特征是缺氧和双侧肺透.
- 如果没有心力衰竭为病因,就会诊断出这种疾病.
- 目前的管理主要是支持.
研究的目的:
- 总结ARDS诊断和管理的关键方面.
- 突出有效和禁忌的治疗策略.
- 提供ARDS结果的概述.
主要方法:
- 对ARDS管理的当前临床指南和证据的审查.
- 专注于支持性护理策略,如机械通风和液体平衡.
- 对严重低氧化症的具体干预措施的评估.
主要成果:
- 保护性机械通风和避免液体过载是ARDS管理的核心.
- 早期的短期神经肌肉阻塞,倾斜位置呼吸或体外膜氧化 (ECMO) 是严重低氧化的选择.
- 吸入氧化,β2激动剂和晚期皮质类固醇一般不适用,应避免使用.
结论:
- 治疗ARDS主要是支持性,强调肺部保护策略.
- 对于严重的病例,有专门的干预措施,但仔细选择患者至关重要.
- 对于ARDS的死亡率仍然很高,约为30%.
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