ARDS患者的肺复张教材教学课件.pptVIP

ARDS患者的肺复张 ALI/ARDS的定义 ALI 急性起病 胸片对称的侵润影 PaO2/FiO2 ? 300 mmHg PAWP ? 18 mmHg或没有左心衰的证据 ARDS 急性起病 胸片对称的侵润影 PaO2/FiO2 ? 200 mmHg PAWP ? 18 mmHg或没有左心衰的证据 ARDS肺部形态学的改变 Puybasset L, et al. Regional distribution of gas and tissue in acute respiratory distress syndrome. I. Consequences for lung morphology. Intensive Care Med 2000; 26: 857-69. ARDS肺部形态学的改变 ARDS患者 健康对照 CT平均密度(HU) -256 ? 21 -654 ? 8 组织容积(ml/m2 BSA) 31.6 ? 1.7 16.7 ? 0.8 气体容积(ml/m2 BSA) 11.5 ? 1.2 32.2 ? 1.8 胸腔内总容积(ml/m2 BSA) 43.0 ? 2.3 49.0 ? 2.5 Gattinoni L, et al. Relationships between lung computed tomographic density, gas exchange a