MEDSCAPE ARDS 一个复杂临床问题.pdfVIP

2015/10/28 [MEDSCAPE]: ARDS: 一个复杂的临床问题 | 中国病理生理学会危重病医学专业委员会 学会动态 学术会议 临床话题 继续教育 进展交流 网站 内容预告 留 言 板 搜索 登录 ⁄ 注册 登录 下次自动登录 夜深了! 2015年10月28 日 星期三 现在的位置: 首页 ＞时讯速递, 进展交流＞正文 RSS 小 中 大 [MEDSCAPE]: ARDS: 一个复杂的临床问题 2015年05月23日 ⁄ 时讯速递, 进展交流 ⁄ 暂无评论 Acute Respiratory Distress Syndrome: A Complex Clinical Condition Dora Izaguirre-Anariba, MD ; Jesus Lanza, MD ; Wojciech Palka, MD ; Klaus D Lessnau, MD, FCCP   |  May 14, 2015 In 1967, Ashbaugh and colleagues reported a case series of 12 patients with lung disease, acute onset of shortness of breath, and hypoxemia.[1-5] They were the first to describe what came to be known as acute respiratory distress syndrome (ARDS) (shown), in which oxygen transfer from the alveoli to the pulmonary capillaries is severely impaired.[1,2,5,6]  (The initial term adult respiratory distress syndrome was revised to acute respiratory distress syndrome, because the syndrome occurs in adults and children.) However, although it has been nearly 50 years since the initial description, the optimal definition of ARDS remains controversial.[2,3,5] 1967年，Ashbaugh及其同事报告了12名肺部疾病患者，这些患者发生呼吸困难和低氧血症[1-5]。Ashbaugh等人首次描述了后来称之为急性呼 吸窘迫综合征(ARDS) （见图）的临床综合征，此时氧从肺泡转运到肺毛细血管的过程出现了严重的障碍[1,2,5,6] （初始的名称为 “成人呼吸 窘迫综合征”，后来改为 “急性呼吸窘迫综合征”，因为这一综合征成人及儿童均可发病。）然而，尽管距离Ashbaugh等首次描述这一综合 征已经过去了将近50年，ARDS的确切定义仍存在争议[2,3,5]。 In 1994, the American-European Consensus Conference (AECC) developed a definition of ARDS[2-5,7]by introducing and defining the term acute lung injury (ALI) with the following criteria[5-7]: 1994年，美国－欧洲共识会议 (AECC)制定的ARDS定义[2-5,7]引入了 “急性肺损伤”这一概念，定义如下[5-7]： Acute onset of respiratory failure, with a ratio of partial pressure of arterial oxygen to fractional inspired oxygen concentration (PaO2/FiO2) of 300 mm Hg or less (regardless of the level of positive end-expir