急性呼吸窘迫综合征诊断标准亟需更新  

Diagnostic criteria of acute respiratory distress syndrome:what to update

作　　者：王永广 朱鹏 许千金 甘桂芬[1] 石钟山 潘纯[3] Yongguang Wang;Peng Zhu;Qianjin Xu;Guifen Gan;Zhongshan Shi;Chun Pan(Department of Critical Care Medicine,Affiliated Hospital of Qinghai University,Xining 810000,China;Department of Critical Care Medicine,People′s Hospital of Golmud City,Gulmud 816099,China;Jiangsu Provincial Key Laboratory of Critical Care Medicine,Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,China)

机构地区：[1]青海大学附属医院重症医学科,西宁810000 [2]格尔木市人民医院重症医学科,青海格尔木816099 [3]江苏省重症医学重点实验室,东南大学附属中大医院重症医学科,南京210002

出　　处：《中华重症医学电子杂志》2024年第2期113-117,共5页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：江苏省卫健委重点项目(ZD2021057);青海省卫健委指导性计划课题(2021-wjzdx-124);青海省海西州2020年度新型冠状病毒感染肺炎防控专项(2020-YZ-L02);四川省科技厅重点研发项目(2022YFS0605);四川省卫健委项目(21PJ082)。

摘　　要：早期诊断急性呼吸窘迫综合征(ARDS)并评估其严重程度是临床治疗与判断预后的关键。目前柏林诊断标准存在起病时间及影像学标准不够精确、缺乏生物标志物辅助诊断、忽视高流量鼻导管氧疗等诸多问题,并且新型冠状病毒感染的流行更扩展了ARDS的范畴。为进一步加深对ARDS的理解并且指导临床治疗,对ARDS诊断标准的更新更为重要,本文围绕ARDS诊断标准需要更新的内容进行讨论。Early identification and diagnosis of acute respiratory distress syndrome(ARDS)and evaluation of ARDS severity are key steps for clinical treatment and predicting prognosis.So far,there are still many issues with Berlin definition of ARDS,such as inaccurate onset time,obscurious imaging criteria,lack of diagnostic biomarkers,absence of criteria for high-flow nasal catheter oxygen therapy.The pandemic COVID-19 has expanded definition of ARDS.In order to make further understanding of ARDS and to guide clinical treatment,updating ARDS diagnostic criteria is necessary and important.This article discusses about what needs to be updated in ARDS diagnostic criteria.

关 键 词：急性呼吸窘迫综合征 诊断 氧合指数 影像学 高流量鼻导管氧疗 

分 类 号：R563.8[医药卫生—呼吸系统]