Clinical review: Early treatment of acute lung injury--paradigm shift toward prevention and treatment prior to respiratory failure.
Clinical review: Early treatment of acute lung injury--paradigm shift toward prevention and treatment prior to respiratory failure.
复制标题
DOI：
10.1186/cc11144
复制
发表时间：
2012-06-19
期刊：
影响因子：
--
通讯作者：
Matthay MA
中科院分区：
文献类型：
--
作者：
Levitt JE;Matthay MA
急性肺损伤（ALI）仍然是危重患者发病和死亡的主要原因。尽管对急性呼吸窘迫的发病机制有了更好的了解，但机械通气的肺保护策略的支持治疗仍然是唯一被证明具有生存优势的治疗方法。大多数ALI临床试验针对的是机械通气患者。过去的药物试验可能未能证明疗效，部分原因是导致开始治疗延迟到肺损伤发生后几天。改善对高危患者的早期识别，为修改危险因素以预防ALI的发展提供了新的机会，并为在进展到需要机械通气之前对ALI进行早期治疗的新患者群体提供了新的目标。本综述将讨论当前预防ALI的策略，以及在需要机械通气的呼吸衰竭发病前早期治疗ALI的一些最有前途的药物。
Acute lung injury (ALI) remains a major cause of morbidity and mortality in critically ill patients. Despite improved understanding of the pathogenesis of ALI, supportive care with a lung protective strategy of mechanical ventilation remains the only treatment with a proven survival advantage. Most clinical trials in ALI have targeted mechanically ventilated patients. Past trials of pharmacologic agents may have failed to demonstrate efficacy in part due to the resultant delay in initiation of therapy until several days after the onset of lung injury. Improved early identification of at-risk patients provides new opportunities for risk factor modification to prevent the development of ALI and novel patient groups to target for early treatment of ALI before progression to the need for mechanical ventilation. This review will discuss current strategies that target prevention of ALI and some of the most promising pharmacologic agents for early treatment of ALI prior to the onset of respiratory failure that requires mechanical ventilation.
登录
查看更多内容
DOI：
10.1186/cc8230
发表时间：
2010
期刊：
Critical care (London, England)
影响因子：
--
作者：
Determann RM;Royakkers A;Wolthuis EK;Vlaar AP;Choi G;Paulus F;Hofstra JJ;de Graaff MJ;Korevaar JC;Schultz MJ
通讯作者：
Schultz MJ
影响因子：
4.4
作者：
Donnino, Michael W.;Cocchi, Michael N.;Shapiro, Nathan I.
通讯作者：
Shapiro, Nathan I.
影响因子：
5.9
作者：
Chalmers, James D.;Singanayagam, Aran;Hill, Adam T.
通讯作者：
Hill, Adam T.
DOI：
10.1164/rccm.200404-544oc
发表时间：
2005-05-01
影响因子：
24.7
作者：
Flori, HR;Glidden, DV;Matthay, MA
通讯作者：
Matthay, MA
影响因子：
9.6
作者：
Calfee, Carolyn S.;Matthay, Michael A.
通讯作者：
Matthay, Michael A.