急性呼吸窘迫综合征诊断标准:需要更新吗?  

Diagnostic criteria for acute respiratory distress syndrome: need an update?

作　　者：杜斌 DU Bin(Medical ICU,Internal Medicine ICU of Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,State Key Laboratory of Complex Severe and Rare Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院,北京协和医院内科ICU,疑难重症及罕见病国家重点实验室,北京100730

出　　处：《中国实用内科杂志》2022年第6期444-447,共4页Chinese Journal of Practical Internal Medicine

基　　金：中国医学科学院医学与健康科技创新工程(2021-I2M-062);国家重点研发计划“常见多发病防治研究”专项(2021YFC2500800)。

摘　　要：急性呼吸窘迫综合征(ARDS)是重症患者常见的临床综合征。自从2012年柏林定义提出以来,针对急性呼吸功能衰竭的临床实践发生了很大改变。高流量鼻导管氧疗(HFNC)的普遍应用,在改善低氧血症患者临床预后的同时,有可能延误ARDS的诊断。部分专家建议在ARDS诊断标准中加入HFNC。然而,根据患者接受的治疗强度诊断疾病或临床综合征是建立在两个错误的前提基础上。Acute respiratory distress syndrome(ARDS)is one of the most common clinical syndromes in critically ill patients. Since the Berlin definition of ARDS was proposed in 2012,the clinical practice of managing patients with acute hypoxemic respiratory failure have been remarkably changed. Although the widespread use of high flow nasal cannula(HFNC)improves clinical outcome of patients with hypoxemia,it may delay the diagnosis of ARDS. Some experts suggest inclusion of HFNC in the diagnostic criteria of ARDS. However,clinical diagnosis of any disease or clinical syndrome according to the treatment intensity is based on two incorrect prerequisites.

关 键 词：急性呼吸窘迫综合征 诊断 定义 

分 类 号：R563.8[医药卫生—呼吸系统]