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首页> 外文期刊>Seminars in Respiratory and Critical Care Medicine >Acute lung injury and acute respiratory distress syndrome: extracorporeal life support and liquid ventilation for severe acute respiratory distress syndrome in adults.
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Acute lung injury and acute respiratory distress syndrome: extracorporeal life support and liquid ventilation for severe acute respiratory distress syndrome in adults.

机译：急性肺损伤和急性呼吸窘迫综合征：成年人的严重急性呼吸窘迫综合征的体外生命支持和液体通气。

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摘要

Acute respiratory distress syndrome (ARDS) has many underlying causes and carries an overall mortality of 40 to 60%. For those patients with severe ARDS who have a predicted mortality of 80 to 100%, extracorporeal life support (ECLS) can provide an extraordinary means of support. We recently demonstrated a survival to hospital discharge of 52% in this subset of patients. ECLS is capable of providing full respiratory and cardiac support, allowing time for the patient to recover from the underlying disease process. Additionally, ventilator settings are reduced to "rest" settings, avoiding the consequences of ventilator-induced lung injury that can contribute to a worse outcome. Systemic heparinization is a mainstay of ECLS therapy because of platelet activation in the circuit. Mechanical complications and significant bleeding can occur in up to one quarter of patients, requiring close attention and prompt intervention should they occur. Although not currently in clinical practice, liquid ventilation using perfluorocarbons to provide gas exchange in the lungs is a potentially useful adjunct in the management of severe respiratory failure.
机译：急性呼吸窘迫综合征（ARDS）有许多潜在原因，总死亡率为40％至60％。对于预期死亡率为80％至100％的重度ARDS患者，体外生命支持（ECLS）可提供非凡的支持手段。最近，我们证明了这部分患者的出院生存率为52％。 ECLS能够提供全面的呼吸和心脏支持，从而使患者有时间从潜在的疾病过程中恢复过来。此外，将呼吸机设置降低为“静止”设置，避免了呼吸机诱发的肺部损伤而导致更糟的后果。由于回路中的血小板活化，全身性肝素化是ECLS治疗的主要手段。机械并发症和大量出血可发生在多达四分之一的患者中，需要密切注意并在发生时及时进行干预。尽管目前尚不在临床实践中，但使用全氟化碳进行肺部气体交换的液体通气在严重呼吸衰竭的治疗中可能是有用的辅助手段。

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