留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肺源性与肺外源性急性呼吸窘迫综合征的再思考

朱然

朱然. 肺源性与肺外源性急性呼吸窘迫综合征的再思考[J]. 协和医学杂志, 2020, 11(5): 528-532. doi: 10.3969/j.issn.1674-9081.2020.05.006
引用本文: 朱然. 肺源性与肺外源性急性呼吸窘迫综合征的再思考[J]. 协和医学杂志, 2020, 11(5): 528-532. doi: 10.3969/j.issn.1674-9081.2020.05.006
Ran ZHU. Reconsideration of Pulmonary and Extra-pulmonary Acute Respiratory Distress Syndrome[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 528-532. doi: 10.3969/j.issn.1674-9081.2020.05.006
Citation: Ran ZHU. Reconsideration of Pulmonary and Extra-pulmonary Acute Respiratory Distress Syndrome[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 528-532. doi: 10.3969/j.issn.1674-9081.2020.05.006

肺源性与肺外源性急性呼吸窘迫综合征的再思考

doi: 10.3969/j.issn.1674-9081.2020.05.006
详细信息
    作者简介:

    朱然,电话:18040097997, E-mail:18040097997@163.com

  • 中图分类号: R563.8

Reconsideration of Pulmonary and Extra-pulmonary Acute Respiratory Distress Syndrome

More Information
  • 摘要: 急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是由一系列疾病损伤导致的急性呼吸衰竭,重症患者具有较高的病死率。根据危险因素的不同,ARDS可分为肺源性ARDS和肺外源性ARDS两种亚型,前者由于损伤直接作用于肺泡上皮细胞,造成肺泡膜破坏,影响气血交换;而后者通过全身性因素导致血管内皮损伤,肺血管通透性增加、肺间质渗出,进而出现肺泡塌陷、水肿,呼吸衰竭。各种肺内外危险因素在重症ARDS患者中往往同时存在,影像和呼吸力学等临床特征也未能很好区分肺源性/肺外源性ARDS,生物标志物的诊断效应还需验证,甚至病死率在肺源性/肺外源性ARDS患者中也并无明显差异。本文对肺源性ARDS和肺外源性ARDS的危险因素、临床特征、病死率进行比较,并针对ARDS的发病机制、临床表现及治疗与预后需关注之处进行梳理,为临床医生更加全面了解ARDS的发病机制、规范系统地启动ARDS的精准化评估与治疗提供借鉴,从而降低ARDS患者的病死率。
    利益冲突:无
  • [1] Derwall M, Martin L, Rossaint R. The acute respiratory distress syndrome: pathophysiology, current clinical practice, and emerging therapies[J]. Expert Rev Respir Med, 2018, 12:1021-1029. doi:  10.1080/17476348.2018.1548280
    [2] Bernard GR, Artigas A, Brigham KL, et al. Report of the American-European Consensus Conference on ARDS: definitions, mechanisms, relevant out-comes, and clinical trial coordination[J]. J Crit Care, 1994, 9:72-81. doi:  10.1016/0883-9441(94)90033-7
    [3] Shaver CM, Bastarache JA. Clinical and biological heterogeneity in acute respiratory distress syndrome: direct versus indirect lung injury[J]. Clin Chest Med, 2014, 35:639-653. doi:  10.1016/j.ccm.2014.08.004
    [4] Kallet RH, Ho K, Lipnick MS, et al. Pulmonary mechanics and gas exchange characteristics in uncommon etiologies of acute respiratory distress syndrome[J]. J Thorac Dis, 2018, 10:5030-5038. doi:  10.21037/jtd.2018.07.78
    [5] Yehya N, Keim G, Thomas NJ. Subtypes of pediatric acute respiratory distress syndrome have different predictors of mortality[J]. Intensive Care Med, 2018, 44:1230-1239. doi:  10.1007/s00134-018-5286-6
    [6] Gattinoni L, Quintel M. Fifty Years of Research in ARDS Why Is Acute Respiratory Distress Syndrome So Important for Critical Care?[J]. Am J Respir Crit Care Med, 2016, 194:1051-1052. doi:  10.1164/rccm.201604-0662ED
    [7] Menezes SL, Bozza PT, Neto HC, et al. Pulmonary and extrapulmonary acute lung injury: inflammatory and ultrastructural analyses[J]. J Appl Physiol (1985), 2005, 98:1777-1783. doi:  10.1152/japplphysiol.01182.2004
    [8] Negri EM, Hoelz C, Barbas CS, et al. Acute remodeling of parenchyma in pulmonary and extrapulmonary ARDS. An autopsy study of collagen-elastic system fibers[J]. Pathol Res Pract, 2002, 198: 355-361. doi:  10.1078/0344-0338-00266
    [9] Gattinoni L, Pelosi P, Suter PM, et al. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes?[J]. Am J Respir Crit Care Med, 1998, 158:3-11. doi:  10.1164/ajrccm.158.1.9708031
    [10] Pelosi P, Caironi P, Gattinoni L. Pulmonary and extrapulmonary forms of acute respiratory distress syndrome[J]. Semin Respir Crit Care Med, 2001, 22:259-268. doi:  10.1055/s-2001-15783
    [11] Tugrul S, Akinci O, Ozcan PE, et al. Effects of sustained inflation and postinflation positive end-expiratory pressure in acute respiratory distress syndrome: focusing on pulmonary and extrapulmonary forms[J]. Crit Care Med, 2003, 31:738-744. doi:  10.1097/01.CCM.0000053554.76355.72
    [12] Lim CM, Kim EK, Lee JS, et al. Comparison of the response to the prone position between pulmonary and extrapulmonary acute respiratory distress syndrome[J]. Intensive Care Med, 2001, 27:477-485. doi:  10.1007/s001340000848
    [13] Goodman LR, Fumagalli R, Tagliabue P, et al. Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations[J]. Radiology, 1999, 213:545-552. doi:  10.1148/radiology.213.2.r99nv42545
    [14] Anan K, Kawamura K, Suga M, et al. Clinical differences between pulmonary and extrapulmonary acute respiratory distress syndrome: a retrospective cohort study of prospectively collected data in Japan[J]. J Thorac Dis, 2018, 10:5796-5803. doi:  10.21037/jtd.2018.09.73
    [15] Yehya N, Thomas NJ, Meyer NJ, et al. Circulating markers of endothelial and alveolar epithelial dysfunction are associated with mortality in pediatric acute respiratory distress syndrome[J]. Intensive Care Med, 2016, 42:1137-1145. doi:  10.1007/s00134-016-4352-1
    [16] Agrawal A, Matthay MA, Kangelaris KN, et al. Plasma angiopoietin-2 predicts the onset of acute lung injury in critically ill patients[J]. Am J Respir Crit Care Med, 2013, 187:736-742. doi:  10.1164/rccm.201208-1460OC
    [17] Calfee CS, Ware LB, Eisner MD, et al. Plasma receptor for advanced glycation end products and clinical outcomes in acute lung injury[J]. Thorax, 2008, 63:1083-1089. doi:  10.1136/thx.2008.095588
    [18] Agarwal R, Aggarwal AN, Gupta D, et al. Etiology and outcomes of pulmonary and extrapulmonary acute lung injury/ARDS in a respiratory in North India[J]. Chest, 2006, 130:724-729. doi:  10.1378/chest.130.3.724
    [19] Armstrong SM, Mubareka S, Lee WL. The lung microvas-cular endothelium as a therapeutic target in severe influenza[J]. Antiviral Res, 2013, 99:113-118. doi:  10.1016/j.antiviral.2013.05.003
    [20] Perl M, Lomas-Neira J, Venet F, et al. Pathogenesis of indirect (secondary) acute lung injury[J]. Expert Rev Respir Med, 2011, 5:115-126. doi:  10.1586/ers.10.92
    [21] Sharp C, Millar AB, Medford AR. Advances in understand-ing of the pathogenesis of acute respiratory distress syndrome[J]. Respiration, 2015, 89:420-434. doi:  10.1159/000381102
    [22] Gattinoni L, Tonetti T, Quintel M. Regional physiology of ARDS[J]. Crit Care, 2017, 21:312. doi:  10.1186/s13054-017-1905-9
    [23] Yoshida T, Amato MBP, Kavanagh BP, et al. Impact of spontaneous breathing during mechanical ventilation in acute respiratory distress syndrome[J]. Curr Opin Crit Care, 2019, 25:192-198. doi:  10.1097/MCC.0000000000000597
    [24] Englert JA, Bobba C, Baron RM. Integrating molecular pathogenesis and clinical translation in sepsis-induced acute respiratory distress syndrome[J].JCI Insight, 2019, 4:e124061. doi:  10.1172/jci.insight.124061
    [25] Wang XT, Ding X, Zhang HM, et al. Lung ultrasound can be used to predict the potential of prone positioning and assess prognosis in patients with acute respiratory distress syndrome[J]. Crit Care, 2016, 20:385. doi:  10.1186/s13054-016-1558-0
    [26] Vieillard-Baron A, Price LC, Matthay MA. Acute cor pulmonale in ARDS[J]. Intensive Care Med, 2013, 39:1836-1838. doi:  10.1007/s00134-013-3045-2
    [27] Peterson SJ, McKeever L, Lateef OB, et al. Combination of High-Calorie Delivery and Organ Failure Increases Mortality Among Patients With Acute Respiratory Distress Syndrome[J]. Crit Care Med, 2019, 47:69-75. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=592605bd99a718a2d0ad138df981ebcc
  • 加载中
计量
  • 文章访问数:  136
  • HTML全文浏览量:  26
  • PDF下载量:  33
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-06-05
  • 刊出日期:  2020-09-30

目录

    /

    返回文章
    返回