病例报告:肺切除术后急性呼吸困扰综合征并发症的原因
Liu Chang1, Li Zhengjun1, Zhang Yumeng2
1Department of Thoracic Surgery, Shenyang Chest Hospital, China.
SAGE open medical case reports
|December 15, 2025
概括
肺癌手术后的术后急性呼吸困扰综合征 (ARDS) 可能是由输血和机械通风引起的. 管理这些因素对于患者的生存至关重要.
科学领域:
- 医学研究 医学研究
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 术后急性呼吸困扰综合征 (ARDS) 是胸部手术后的严重并发症,特别是肺切除.
- 将术前输血和机械通风与ARDS联系在一起的确切机制尚不清楚.
- 尽管术后护理的进步,但ARDS的死亡率很高.
研究的目的:
- 探索两个非小细胞肺癌患者肺切除后的ARDS发生情况.
- 研究在ARDS发展中的手术内输血和机械通风参数之间的关联.
- 为了突出肺切除后ARDS的关键性质.
主要方法:
- 两个患有非小细胞肺癌的患者进行肺切除的案例研究.
- 分析手术期间输血量和机械通风参数 (峰值平原压力,潮量).
- 术后重症监护管理包括机械通风,流体管理和药物治疗.
主要成果:
- 两位患者都在手术内接受了>2U红细胞,并且有高峰平原压力 (30-31cmH2O),潮体积为6-8mL/kg.
- 两位患者都出现了术后急性肺和低氧化症,需要密集护理.
- 一名患者康复了,而另一个ARDS患者死亡.
结论:
- 肺切除后的ARDS是由于输血相关的炎症,机械通风压力和肺储量减少的联合侮辱造成的.
- 肺部保护性呼吸,限制性输血策略和多学科护理对于改善结果至关重要.
- 需要进一步的多中心研究来验证因果机制,并开发有针对性的疗法来降低ARDS死亡率.
更多相关视频
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
3.1K
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
3.8K
相关概念视频
Pulmonary Cycle: Exhalation
5.5K
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
5.5K
Acute Respiratory Failure-II
1.8K
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:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.8K
Acute Respiratory Failure-III
1.3K
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...
1.3K
Acute Respiratory Failure-IV
828
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...
828
Acute Respiratory Failure-V
773
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...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
773
Endoscopic Studies II: Thoracocentesis
2.5K
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
2.5K
