全球对急性呼吸不良综合征的新定义
Michael A Matthay1,2,3, Yaseen Arabi4, Alejandro C Arroliga5
1Department of Medicine.
概括
对急性呼吸困难综合征 (ARDS) 的新全球定义扩大了标准,包括高流量鼻氧和脉冲氧计. 这一更新的定义旨在实现更广泛的适用性,特别是在资源有限的环境中.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 2012年柏林对急性呼吸困扰综合征 (ARDS) 的定义需要更新,因为呼吸支持和诊断方面的进步.
- 像高流量鼻氧,脉冲氧度和超声波成像等新技术需要修订ARDS定义.
- 越来越需要一种ARDS定义,适用于各种临床环境,包括资源有限的环境.
研究的目的:
- 为急性呼吸困难综合征 (ARDS) 制定一个更新的全球定义.
- 创建一个定义,以促进临床护理和研究的快速诊断.
- 确保定义是实际的,在资源有限的环境中适用,并在临床试验中有用.
主要方法:
- 召开了一个共识会议,涉及32名重症监护专家.
- 虚拟会议于2021年6月至2022年3月举行,来自重症监护协会的投入.
- 该过程的重点是在ARDS框架内识别患者,使得快速诊断,并确保全球适用性.
主要成果:
- 建议包括高流量鼻氧 (>=30 L/min) 和使用脉冲氧计 (SpO2:FiO2 <= 315) 更新的低氧标准.
- 双边不透明度仍然是成像的主要标准,超声波作为一种模式,特别是在资源有限的地区.
- 在资源有限的环境中,对正极呼气压,特定氧气流量或设备的要求是不必要的.
结论:
- 提出了一个新的ARDS全球定义,基于现有的柏林定义.
- 修订后的定义包括了现代呼吸辅助和诊断工具.
- 未来的研究应该专注于对新的全球ARDS定义的可行性,可靠性和预后准确性的前性验证.
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