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俯卧位在重度急性呼吸窘迫综合征治疗中的运用进展
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Abstract:
急性呼吸窘迫综合征属于较为常见的一种危及人类呼吸安全，关乎人类生命安全的呼吸系统重症表现。患者可在短时间内出现肺部损伤，且呈现出急性和弥漫性，需采取及时的通气治疗，以维持患者气道通畅，挽救患者生命安全，并为其后续治疗创造有利条件，改善预后。俯卧位多用于改善重度急性呼吸窘迫综合征患者氧合，特别是新冠病毒大流行期间，俯卧位广泛应用于临床中，取得良好效果。现就俯卧位在重度ARDS治疗中的作用机制作一综述。
Acute respiratory distress syndrome is a common severe manifestation of respiratory system, which endangers human respiratory safety and is related to human life safety. Patients can have lung injury in a short period of time, and it is acute and diffuse. Timely ventilation treatment is needed to maintain the patient’s airway patency, save the patient’s life safety, and create favorable conditions for its follow-up treatment and improve the prognosis. The prone position is mostly used to improve oxygenation in patients with severe acute respiratory distress syndrome. Especially during the novel coronavirus pandemic, the prone position is widely used in clinical practice to determine good application results. This article reviews the mechanism of prone position in the treatment of severe ARDS.
| [1] | Matthay, M.A., Arabi, Y., Arroliga, A.C., Bernard, G., Bersten, A.D., Brochard, L.J., et al. (2024) A New Global Definition of Acute Respiratory Distress Syndrome. American Journal of Respiratory and Critical Care Medicine, 209, 37-47. https://doi.org/10.1164/rccm.202303-0558ws |
| [2] | Meyer, N.J., Gattinoni, L. and Calfee, C.S. (2021) Acute Respiratory Distress Syndrome. The Lancet, 398, 622-637. https://doi.org/10.1016/s0140-6736(21)00439-6 |
| [3] | Xu, H., Sheng, S., Luo, W., Xu, X. and Zhang, Z. (2023) Acute Respiratory Distress Syndrome Heterogeneity and the Septic ARDS Subgroup. Frontiers in Immunology, 14, Article 1277161. https://doi.org/10.3389/fimmu.2023.1277161 |
| [4] | Lin, H., Liu, Q., Zhao, L., Liu, Z., Cui, H., Li, P., et al. (2023) Circulating Pulmonary-Originated Epithelial Biomarkers for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. International Journal of Molecular Sciences, 24, Article 6090. https://doi.org/10.3390/ijms24076090 |
| [5] | Papazian, L., Aubron, C., Brochard, L., Chiche, J., Combes, A., Dreyfuss, D., et al. (2019) Formal Guidelines: Management of Acute Respiratory Distress Syndrome. Annals of Intensive Care, 9, 18-69. https://doi.org/10.1186/s13613-019-0540-9 |
| [6] | Griffiths, M.J.D., McAuley, D.F., Perkins, G.D., Barrett, N., Blackwood, B., Boyle, A., et al. (2019) Guidelines on the Management of Acute Respiratory Distress Syndrome. BMJ Open Respiratory Research, 6, e000420. https://doi.org/10.1136/bmjresp-2019-000420 |
| [7] | Grasselli, G.C.C.C.L. (2023) European Society of Intensive Care Medicine Taskforce on ARDS. ESICM guidelines on Acute Respiratory Distress Syndrome: Definition, Phenotyping and Respiratory Support Strategies. Intensive Care Medicine, 49, 727-759. |
| [8] | Giani, M.M.G.M.F. (2021) Prone Positioning during Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome. A Multicenter Cohort Study and Propensity-Matched Analysis. Annals of the American Thoracic Society, 18, 13-18. |
| [9] | Sud, S., Friedrich, J.O., Adhikari, N.K.J., Fan, E., Ferguson, N.D., Guyatt, G., et al. (2021) Comparative Effectiveness of Protective Ventilation Strategies for Moderate and Severe Acute Respiratory Distress Syndrome. a Network Meta-Analysis. American Journal of Respiratory and Critical Care Medicine, 203, 1366-1377. https://doi.org/10.1164/rccm.202008-3039oc |
| [10] | Subgroup, O.C.R.D. (2020) Standardized Protocol of Prone Position Ventilation in Patients with Acute Respiratory Distress Syndrome. Chung-hua nei kʿo tsa chih, 59, 781-787. |
| [11] | Walter, T. and Ricard, J. (2023) Extended Prone Positioning for Intubated ARDS: A Review. Critical Care, 27, Article No. 264. https://doi.org/10.1186/s13054-023-04526-2 |
| [12] | Walter, T., Zucman, N., Mullaert, J., Thiry, I., Gernez, C., Roux, D., et al. (2022) Extended Prone Positioning Duration for Covid-19-Related ARDS: Benefits and Detriments. Critical Care, 26, Article No. 208. https://doi.org/10.1186/s13054-022-04081-2 |
| [13] | Rossi, S., Palumbo, M.M., Sverzellati, N., Busana, M., Malchiodi, L., Bresciani, P., et al. (2021) Mechanisms of Oxygenation Responses to Proning and Recruitment in COVID-19 Pneumonia. Intensive Care Medicine, 48, 56-66. https://doi.org/10.1007/s00134-021-06562-4 |
| [14] | Zarantonello, F., Sella, N., Pettenuzzo, T., Andreatta, G., Calore, A., Dotto, D., et al. (2022) Early Physiologic Effects of Prone Positioning in COVID-19 Acute Respiratory Distress Syndrome. Anesthesiology, 137, 327-339. https://doi.org/10.1097/aln.0000000000004296 |
| [15] | Guérin, C., Reignier, J., Richard, J., Beuret, P., Gacouin, A., Boulain, T., et al. (2013) Prone Positioning in Severe Acute Respiratory Distress Syndrome. New England Journal of Medicine, 368, 2159-2168. https://doi.org/10.1056/nejmoa1214103 |
| [16] | Papolos, A.I., Schiller, N.B., Belzer, A., Zhuo, H., Gotts, J.E., Bibby, D., et al. (2019) Pulmonary Dead Space Monitoring: Identifying Subjects with ARDS at Risk of Developing Right Ventricular Dysfunction. Respiratory Care, 64, 1101-1108. https://doi.org/10.4187/respcare.06544 |
| [17] | Boesing, C., Krebs, J., Conrad, A.M., Otto, M., Beck, G., Thiel, M., et al. (2024) Effects of Prone Positioning on Lung Mechanical Power Components in Patients with Acute Respiratory Distress Syndrome: A Physiologic Study. Critical Care, 28, Article No. 82. https://doi.org/10.1186/s13054-024-04867-6 |
