严重急性呼吸困难综合征的管理:一本初级书籍
John C Grotberg1, Daniel Reynolds2, Bryan D Kraft2
1Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA. grotberg@wustl.edu.
Critical care (London, England)
|July 18, 2023
概括
严重急性呼吸困扰综合征 (ARDS) 管理侧重于肺部保护性通风,proning和流体策略. 辅助疗法和静脉静脉体外膜氧化 (V-V ECMO) 有助于耐火性低氧症,改善了关键ARDS病例的存活率.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 生理学 生理学 生理学
背景情况:
- 在COVID-19大流行期间,严重急性呼吸系统应急综合征 (ARDS) 病例在全球范围内激增,与高死亡率有关.
- 有效的管理策略对于改善ARDS患者的生存率和减少对呼吸机的依赖至关重要.
研究的目的:
- 审查耐火性低氧血症严重ARDS的生理学和基于证据的管理.
- 讨论机械通风,辅助疗法和V-V ECMO作为治疗方式.
主要方法:
- 关于严重ARDS管理的当前文献的叙事综述.
- 专注于机械通风策略,包括个性化设置和肺部保护性通风.
- 探索辅助疗法和V-V ECMO用于耐火性低氧症.
主要成果:
- 节,保守的流体管理和肺部保护性通风是生存的关键.
- 个性化呼吸机设置,包括PEEP定位和减轻驱动压力/机械功率,可以减少呼吸机引起的肺损伤 (VILI).
- 救援通风模式,辅助疗法和V-V ECMO为耐火性低氧症提供了选择,V-V ECMO改善了气体交换和适度提高了生存率.
结论:
- 严重的ARDS是异质的,需要个性化治疗.
- 需要进一步的研究来确定ARDS子组,以量身定制的治疗方法.
- 管理应专注于肺部休息,VILI预防和优化气体交换.
关键词:
急性心肺炎是什么情况急性呼吸困扰综合征是什么驱动压力 驱动压力 驱动压力电阻断层扫描仪电阻断层扫描仪消化管的测量方法是食管的测量.身体外膜氧化器的氧化机械动力 机械动力 机械动力积极的终端呼气压力.更多相关视频
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