ARDS 병태생리와 case 대학병원 발표 70페이지 marinos the little icu book 참고
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"ARDS 병태생리와 case 대학병원 발표 70페이지 marinos the little icu book 참고"에 대한 내용입니다.목차
1. ARDS특징 (FEATURES)
기계 환기 (MECHANICAL VENTILATION)
기타 조치 (OTHER MEASURES)
불용성 저 산소혈증 (REFRACTORY HYPOXEMIA)
2. CASE
본문내용
ARDS급성 호흡 곤란 증후군 (Acute Respiratory Distress Syndrome, ARDS)
ICU 입원의 10%, 전 세계적으로, 장기간 기계 환기치료하는 환자의 25%를 차지하는 미만성 염증성 폐 손상을 말한다 (1).
<중 략>
A. 발병기전 (Pathogenesis)
ARDS는 순환하는 호중구의 활성화 (전신성 염증반응의 일부로서)로부터 시작된다.
활성화된 호중구는 폐모세혈관의 내피에 부착하고, 이어서 폐 실질 (Lung parenchyma)로 이동한다
호중구의 탈과립은 모세혈관내피 세포의 손상을 일으켜 단백질이 풍부한 삼출액이 원위폐포공간 (distal air-(space)을 채우고 폐포의 가스교환장애를 일으킨다.
참고 자료
Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016;315:788 - 800.Abraham E. Neutrophils and acute lung injury. Crit Care Med 2003; 31(Suppl): S195 - S199.
The ARDS Definition Task Force. Acute respiratory distress syndrome. The Berlin definition. IAMA 2012: 3072526-2533, поиран полня се раН уПро. З
Rubenfeld GD, Caldwel B., Granton J, et al, Interobserver variablity in aplyinga radiographic definition for ARDS. Chest 1999; 116:1347 - 1353. 5 de Hemptinne Q, Remmelink M. Brimioulle S, etal, ARDS; a clinicopathologica 6 contion die, A tias A, Brigham Kt., ctal. The American - European Consense confrontation, Chest 2009; 135:944 - 949. Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am Rev Respir Crit Care Med 1994; 149:818 – 824
Rouby J-J, Purbasset L, Nieszkowska A, Lu Q. Acute respiratory distress syn-drome: Lessons from computed tomography of the whole lung. Crit Care Med 2003; 31(Suppl): S285 - 5295.
Dreyfuss D, Saumon G. Ventilator-induced lung injury: lessons from experimental studies. Am ] Respir Crit Care Med 1998; 157:294 - 323. OlIS
Gattinoni L., Protti A, Caironi P. Carlesso E. Ventilator-induced lung injury: the anatomical and physiological framework. Crit Care Med 2010; 38(Suppl): S539 5548. AJo fo to fe f (OMOR) 호소
Muscedere ]G, Mullen ]BM, Gan K, et al. Tidal ventilation at low airway pressures can augment lung injury. Am J Respir Crit Care Med 1994; 149:1327 - 1334.
Brower RG, Rubenfeld GD. Lung-protective ventilation strategies in acute lung in-jury. Crit Care Med 2003; 31(Suppl):S312 - S316.
Santa Cruz R, Rojas J, Nervi R, et al. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2013: CD009098.
BidaniA, Tzouanakis AE, Cardenas V, Zwischenberger JB. Permissive hypercap-nia in acute respiratory failure. JAMA 1994; 272:957 - 962.
Hickling KG, Walsh J, Henderson S, et al. Low mortality rate in adult respiratory distress syndrome using low-volume, pressurelimited ventilation with permissive hypercapnia: A prospective study. Crit Care Med 1994; 22:1568 - 1578.
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New Engl J Med 2000; 342:1301 - 1308.
Fan E, Needham DM, Stewart TE. Ventilator management of acute lung injury and acute respiratory distress syndrome. JAMA 2005; 294:2889 - 2896
The Acute Respiratory Distress Syndrome Network, Comparison of two fluid management stratagies in acute lung injury mentin acute lung injury secondary to septic shock, Chest 2009: 136:102 - 109.
Berlin I, Grasso S, Moerer O, et al. The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia. Intensive Care Med 2016; 42:699 - 711.
Tonelli AR, Zein J, Adams ], Ioannidis JPA. Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 2014; 40:769 - 787.
Pipeling MR, Fan E. Therapies for refractory hypoxemia in acute respiratory distress syndrome. JAMA 2010; 304:2521 - 2527.
Mercat A, Richard J-C, Vielle B, et al. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome. JAMA 2008; 299:646-655.
Kallet RH. Patient-ventilator interaction during acute lung injury, and the role of spontaneous breathing: Part 2: airway pressure release ventilation. Respir Care 2011; 56:190 - 206.
Facchin F, Fan E. Airway pressure release ventilation and high frequency oscillatory ventilation: potential strategies to treat severe hypoxemia and prevent ventilator-induced lung injury. Respir Care 2015; 60:1509 - 1521.
Ventetuolo CE, Muratore Cs. Extracorporeal life support in critically ill adults. Am Rev Respir Crit Care Med 2014; 190:497 - 508. iC Y101s. 31. Tramm R. Ilic D, Davies AR, et al. Extracorporeal membrane oxygenation for critically ill adults. Cochrane Database Syst Rev 2015; 1:CD010381./