ards診斷治療指南講義-資料下載頁
2025-05-25 22:31本頁面
【正文】 e f r e e d ays I C U f r e e d aysP l a c e b oS t e r o i dP= P= P= Effect of steroid on oute of ARDS P=%%20%25%30%35%Placebo SteroidMortality at 60dP=%%20%25%30%35%Placebo SteroidMortality at 180dOute vs Steroid at ARDS onset 713d vs 14d P=36%27%0%10%20%30%40%50%Placebo SteroidSteroid at 713dMortality at 60dP=39%27%0%10%20%30%40%50%Placebo SteroidSteroid at 713dMortality at 180dP=%%0%10%20%30%40%50%Placebo SteroidSteroid at 14dMortality at 60dP=%%0%10%20%30%40%50%Placebo SteroidSteroid at 14dMortality at 180d 糖皮質(zhì)激素在 ARDS的應(yīng)用 推薦意見 17 不推薦應(yīng)用糖皮質(zhì)激素預(yù)防治療 ARDS (推薦級(jí)別： B級(jí) ) 一氧化氮 (NO) ? NO在短時(shí)間內(nèi)可使約 60%ARDS患者氧合改善 ? NO吸入不能改善 ARDS患者病死率 (2 RCT trials) ? Prospective, multicenter, randomized, doubleblind, placebocontrolled, phase II trial ? 177 ARDS patients (placebo VS inhaled NO) ? acute response to treatment gas, defined as PaO2 Increase ≥ 20% Crit Care Med, 1998, 26: 1523. Figure 3. The percentage of patients in each dose group with an acute (or=to20% increase in PaO2) response to treatment gas over the first 4 hrs of treatment gas. 推薦意見 18 不推薦吸入 NO作為 ARDS病人常規(guī)治療 (推薦級(jí)別： A級(jí) ) Effect of Omega3 fatty acids on oute in ARDS ? To explore the effects of an enteral diet enriched with EPA, GLA and antioxidants on pats with ALI ? Singlecenter, prospective, randomized, controlled, unblinded study. ? N= 100 pat with acute lung injury ? Group: standard isonitrogenous, isocaloric enteral diet OR the standard diet + EPA and GLA for 14 ds Singer P. Crit Care Med. 2022, 34:1033 230214236207317296150170190210230250270290310330Base D4(P) D7(P)PaO2/FiO2 (mmHg).C o ntro lEP A + GI A44355155102030405060Base D7(P)ComplianeC o ntro lEP A + GI A? EPA+GLA ? 顯著改善氧合 ? 明顯改善肺順應(yīng)性 ? 明顯縮短機(jī)械通氣時(shí)間 ? Mortality: 35% vs 37% (P) Omega3 fatty acids在 ARDS的應(yīng)用 推薦意見 19 可通過腸內(nèi)或靜脈途徑給予 ALI/ARDS病人補(bǔ)充 EPA和 γ亞油酸以改善氧合，縮短機(jī)械通氣時(shí)間 (推薦級(jí)別： C級(jí) ) 中華醫(yī)學(xué)會(huì)重癥醫(yī)學(xué)分會(huì) 編寫工作小組成員 (按姓氏筆畫排序 ) 馬曉春，王辰，方強(qiáng)，劉大為，邱海波，秦英智，席修明，黎毅敏 Thanks for your attention
環(huán)評(píng)公示相關(guān)推薦
鄂ICP備17016276號(hào)-1