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Bench-to-bedside review: Distal airways in acute respiratory distress syndrome

机译：从病床到病床的回顾：急性呼吸窘迫综合征中的远端气道

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Distal airways are less than 2 mm in diameter, comprising a relatively large cross-sectional area that allows for slower, laminar airflow. The airways include both membranous bronchioles and gas exchange ducts, and have been referred to in the past as the 'quiet zone', in part because these structures were felt to contribute little to lung mechanics and in part because they were difficult to study directly. More recent data suggest that distal airway dysfunction plays a significant role in acute respiratory distress syndrome. In addition, injurious mechanical ventilation strategies may contribute to distal airway dysfunction. The presence of elevated airway resistance, intrinsic positive end-expiratory pressure or a lower inflection point on a pressure–volume curve of the respiratory system may indicate the presence of impaired distal airway function. There are no proven specific treatments for distal airway dysfunction, and protective ventilation strategies to minimize distal airway injury may be the best therapeutic approach at this time.
机译：远端气道的直径小于2毫米，包括较大的横截面积，可允许较慢的层流。气道包括膜性细支气管和气体交换管，过去被称为“安静区”，部分原因是这些结构被认为对肺部力学影响不大，部分原因是它们难以直接研究。最近的数据表明，远端气道功能障碍在急性呼吸窘迫综合征中起重要作用。此外，有害的机械通气策略可能导致远端气道功能障碍。呼吸道压力升高，固有呼气末正压通气或呼吸系统压力-容量曲线上较低的拐点存在，可能表明远端呼吸道功能受损。目前尚无针对远端气道功能障碍的经证实的具体治疗方法，目前，保护通风策略以最小化远端气道损伤可能是最佳的治疗方法。

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