急性呼吸窘迫症候群呼吸治療之新進展

Recent Advances in Respiratory Therapy for Acute Respiratory Distress Syndrome

鄒志翔(Chih-Hsiang Tsou)

《北市醫學雜誌》 4卷9_S期 (2007/12) Pp. 919-925

https://doi.org/10.6200/TCMJ.2007.4.9.16

摘要

急性呼吸窘迫症候群為－高死亡率之症候群，可由眾多病因誘發肺部嚴重發炎反應，而產生一連串之病態生理變化。急性呼吸窘迫症候群的最主要死因為多重器官衰竭，治療主要為支持性療法，此類病人多半必須使用機械性通氣治療。目前機械通氣治療策略主要包括有低潮器容積、高吐氣末端壓力、容許性高碳酸血症、和逆轉吸吐氣比等治療策略。除了以上治療策略外，吾人也必須盡量維持乾肺，最近幾年類固醇的角色被重新檢視；俯臥姿、支氣管擴張劑、表面張力劑、前列腺素、高頻振盪通氣、體外膜性氧合術、體外二氧化碳排除術、血管內氧合術、部分液態通氣法等改善氧合方法也都被探討中，但是對於改善病人存活率仍然需要被進一步驗證。

關鍵字

急性呼吸窘迫症候群 ； 機械通氣 ； 類固醇

並列摘要

Acute respiratory distress syndrome (ARDS) is a challenge to all of doctors. The etiology of acute respiratory distress syndrome is diverse. The main cause of death for acute respitratory distress syndrome is multiple organ failure. The mainstay of management of ARDS is supportive care, which includes avoidance of iatrogenic complication, treatment of underlying disease and improving oxygenation. Protective lung strategy for ventilation has been proven to improve 28-day survival rate for ARDS. The role of low dose steroid in ARDS seems to improve the oxygenation rather than the survival rate. The other stategy of ventilation such as inhaled NO, high frequency oscillation ventilation etc need to be further investigated.

並列關鍵字

acute respiratory distress syndrome ； mechanical ventilation ； steroids