Inflammation and the acute respiratory distress syndrome.
Inflammation and the acute respiratory distress syndrome.
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DOI：
10.1016/s1521-6896(03)00121-6
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发表时间：
2004-09-01
期刊：
影响因子：
--
通讯作者：
Slutsky, Arthur S
中科院分区：
文献类型：
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作者：
Crimi, Ettore;Slutsky, Arthur S
急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）是一种非心源性肺水肿的临床综合征，主要表现为双侧肺浸润、僵硬肺和顽固性低氧血症。ARDS的特征是肺实质中爆发性急性炎症反应，导致肺泡水肿，肺顺应性降低，最终导致低氧血症。虽然我们对ARDS的病因和病理生理学的了解有所增加，但其死亡率仍在30- 50%的范围内。在药物治疗方面没有取得重大进展。机械通气是ARDS的主要治疗手段。唯一的方法，已被证明，以减少炎症反应和死亡率是使用肺保护性呼吸策略与低潮气量和高呼气末正压。本章将回顾目前状态的文献对ARDS的发病机制和治疗和药物治疗的方法，其管理。
Acute respiratory distress syndrome (ARDS) is a clinical syndrome of non-cardiogenic pulmonary oedema associated with bilateral pulmonary infiltrates, stiff lungs and refractory hypoxaemia. ARDS is characterized by an explosive acute inflammatory response in the lung parenchyma, leading to alveolar oedema, decreased lung compliance and, ultimately, hypoxaemia. Although our understanding of the causes and pathophysiology of ARDS has increased, the mortality rate remains in the range of 30-50%. No major advances in pharmacological therapy have been achieved. Mechanical ventilation is the main therapeutic intervention in the management of ARDS. The only approach that has been shown to reduce the inflammatory response and mortality is the use of lung-protective ventilatory strategy with a low tidal volume and high positive-end expiratory pressure. This chapter will review the current state of the literature on the pathogenesis of ARDS and ventilatory and pharmacotherapy approaches to its management.