[成人急性呼吸窘迫综合征(ARDS)和人工呼吸-手术重症监护患者的结果]。

A Deller, F Konrad, D Spilker, J Kilian
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引用次数: 0

摘要

在某手术重症监护病房进行前瞻性临床试验,探讨成人呼吸窘迫综合征(ARDS)患者的发生率和转转率,以及重症监护患者机械通气的转转率和气压创伤和肺部感染的发生率。161例机械通气患者总死亡率为19.9%。ARDS患者死亡率为11 / 26。这些ARDS患者大多死于多器官衰竭。肺部感染是机械通气最常见的并发症。我们从这些数据中得出结论:根据文献,外科ICU患者机械通气合并ARDS和不合并ARDS的结果比内科ICU患者更有利;——只有提供准确和详细的标准,才能解释ARDS患者的治疗结果和流行病学数据;这些数据应包括合规数据;-通过与先前数据的比较来评估当前ARDS治疗,即使应用相同的标准,例如ecmo标准,也可能失败,因为常规治疗测量(机械通气)的结果可能有所改善。对照随机试验可能更适合评估ARDS的替代疗法。
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[Acute respiratory distress syndrome of the adult (ARDS) and artificial respiration--results in surgical intensive care patients].

A prospective clinical trial was performed in an operative intensive care unit to examine the incidence and outcome of patients with adult respiratory distress syndrome (ARDS) and the outcome of intensive care patients on mechanical ventilation and the incidence of barotrauma and pulmonary infection. 161 mechanically ventilated patients showed an overall mortality of 19.9%. The mortality rate in the ARDS patients was 11 of 26. Most of these patients with ARDS died from multiorgan failure. Pulmonary infection was the most frequently registrated complication of mechanical ventilation. We conclude from these data that --according to the literature the outcome of surgical ICU patients on mechanical ventilation with and without ARDS is more favourable than that of medical ICU patients; --the interpretation of therapeutic results and of epidemiological data in ARDS patients is possible only by providing exact and detailed criteria; these should include compliance data; --evaluation of present ARDS therapy by comparison to previous data, even when the same criteria are applied, e.g. ECMO-criteria, may fail as the outcome of conventional therapeutic measurements - mechanical ventilation - may have improved. A controlled randomised trial might be more suitable for evaluation of alternative therapy in ARDS.

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