急性呼吸窘迫综合征

急性呼吸窘迫综合征是急危重病医学中的重要论题。近年来，有人认为它是全身性过度炎症反应综合征的肺部表现，也有人认为它是多器官功能不全的始动器官。本文回顾了急性呼吸窘迫综合征的定义变迁，流行病学，自然史，致病机理及新的治疗策略。现在，急性呼吸窘迫综合症的早期诊断靠PaO2／FiO2比值，致病机理主要是中性粒细胞依赖的，或细胞因子相关的内皮和上皮细胞损伤。认识到在急性呼吸窘迫综合征，加速吸收消退的办法也许最终和缓解早期肺部炎症反应一样重要。低潮通气降低了急性呼吸窘迫综合征的死亡率，高频通气在呼吸窘迫综合征中显示了强大的优势。

Acute respiratory distress syndrome

Acute respiratory distress syndrome(ARDS)is the major issue of the critical care medicine. These days it was considered by some scholars as pulmonary manifestation of systemic inflammatory response syndrome,and also considered as initiating organ of multiple organ dysfunction syndrome. This paper reviewed changes of definition, epidemiology, pathogenesis and treatment strategy of ARDS. PaO2/FiO2 ratio is the early and primary diagnosis of ARDS. Neutrophil-dependent or cytokine-associated endothelial and epithelial injury is the major pathogenesis of ARDS. Promotion of absorption is as important as attenuation of early pulmonary inflammatory reaction in ARDS. Low tidal volume ventilation reduced the mortality of ARDS and high frequency oscillatory ventilation showed the powerful advantages for the treatment of ARDS.