
A New Global Definition of Acute Respiratory Distress Syndrome
文章来源:PubMed
摘要信息:Background. Since the 2012 Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS), several developments have supported the need for an expansion of the definition, including the use of high flow nasal oxygen (HFNO), expanding use of pulse oximetry in place of arterial blood gases, use of ultrasound for chest imaging, and the need for applicability in resource-limited settings. Methods. A Consensus Conference of 32 critical care ARDS experts was convened, had six virtual meetings (June 2021-March 2022), and subsequently obtained input from members of several critical care societies. The goal was to develop a definition that would: (1) identify patients with the currently accepted conceptual framework for ARDS; (2) facilitate rapid ARDS diagnosis for clinical care and research; (3) be applicable in resource-limited settings; (4) be useful for testing specific therapies; and (5) be practical for communication to patients and caregivers. Results. The committee made four main recommendations: (1) Include HFNO with a minimum flow rate of 30 liters/min; (2) Use arterial oxygen tension (PaO2)/FiO2 300 mmHg or SpO2/FiO2 < 315 (if SpO2 97%) to identify hypoxemia; (3) Retain bilateral opacities for imaging criteria but add ultrasound as an imaging modality, especially in resource-limited areas; and (4) In resource-limited settings, do not require PEEP, oxygen flow rate, or specific respiratory support devices. Conclusions. We propose a New Global Definition of ARDS that builds on the Berlin Definition. The recommendations also identify areas for future research, including the need for prospective assessments of feasibility, reliability, and prognostic validity of the proposed Global Definition.

中性粒细胞弹性蛋白酶与皮层下动脉硬化性脑病的相关性研究
摘要信息:[摘要] 目的 探讨中性粒细胞弹性蛋白酶(NE)与皮层下动脉硬化性脑病(SAE)的相关性。方法 选择 SAE 患者 60 例,按 GOTO 分型分为I型、Ⅱ 型及 Ш型即 A、B、C组,各 20 例,另选健康体检者 20 例设为对照组,检测各组血浆 NE含量。结果,对照织与病例组 NE含量差异均有统计学意义(均 P< 0.05):不同严重程度组间 NE含量差异有统计学意义(P< 0.05):I型与Ⅲ型组 NE含量差异有统计学意义(P< 0.05)。结论SAE 患者血浆 NE水平随着病情严重程度加重而升高。