肺复张在急性呼吸窘迫综合征中的应用和临床进展  

Current application and advances in lung recruitment in ARDS

作　　者：史楠 袁雪燕 邱海波[1] Nan Shi;Xueyan Yuan;Haibo Qiu(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]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,南京210009

出　　处：《中华重症医学电子杂志》2024年第2期118-126,共9页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：国家自然科学基金专项(82341032);国家自然科学基金重点项目(81930058);科技部国家重点研发计划项目(2022YFC2504400)。

摘　　要：机械通气是治疗急性呼吸窘迫综合征(ARDS)的重要手段,然而不恰当的机械通气策略会引起呼吸机相关肺损伤(VILI)。肺复张可减少萎陷伤和剪切伤,但也可能增加容积伤。然而,多年来,相关的随机对照研究并未证实肺复张能改善ARDS病死率。本文从肺复张的病理生理机制、方法和监测展开讨论,发现选择具有肺可复张性的人群是一个重要因素。ARDS患者中影响肺复张的主要因素包括病因、病变严重程度和类型。本文就肺复张在ARDS中的应用和临床进展进行综述,旨在为未来肺复张在ARDS中的研究提供方向。Mechanical ventilation(MV)is one of the most important management in acute respiratory distress syndrome(ARDS)patients,but also leading to ventilator-induced lung injury(VILI)when inappropriate applied.Lung recruitment is able to decrease atelectrauma and shear strain,but with the risk of volutrauma.For decades,randomized clinical trials(RCTs)on lung recruitment have not concluded to improve mortality in ARDS.This paper reviews pathophysiological mechanism,methods and monitoring during lung recruitment,which discovering that it is important to find recruitable ARDS patients.The factors affecting results of lung recruitment include etiology,severity and classification of ARDS.This article reviews current application and advances in lung recruitment in ARDS in order to find further research topics.

关 键 词：急性呼吸窘迫综合征 肺复张 可复张性 主要因素 

分 类 号：R563.8[医药卫生—呼吸系统]