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阅读时间：10分钟 坐稳了没？要开车了哦  编译 ARDS：患者治疗与前沿研究的挑战  昨天读到了欧洲呼吸病综述《European Respiratory Review》的如下文献： ARDS: challenges in patient care and frontiers in research （ARDS：患者治疗与前沿研究的挑战） Lieuwe D. Bos, Ignacio Martin-Loeches, Marcus J. Schultz European Respiratory Review 2018 27: 170107; DOI: 10.1183/16000617.0107-2017 http://err./content/27/147/170107 （提示文末有福利！） 我觉得很好，尤其是其中的观点也代表着新进学界的思潮和反思。我觉得不如翻译出来供大家参考，不过在写完摘要译稿的时候（写了一堆的好几段，这即使是综述也较少看到的），我突然觉得单纯的翻译实在不过瘾，做一个课件是极好的。 This review discusses the clinical challenges associated with ventilatory support and pharmacological interventions in patients with acute respiratory distress syndrome (ARDS). In addition, it discusses current scientific challenges facing researchers when planning and performing trials of ventilatory support or pharmacological interventions in these patients. Noninvasive mechanical ventilation is used in some patients with ARDS. When intubated and mechanically ventilated, ARDS patients should be ventilated with low tidal volumes. A plateau pressure <30 cmh2o is="" recommended="" in="" all="" patients.="" it="" is="" suggested="" that="" a="" plateau="" pressure=""><15 cmh2o="" should="" be="" considered="" safe.="" patient="" with="" moderate="" and="" severe="" ards="" should="" receive="" higher="" levels="" of="" positive="" end-expiratory="" pressure="" (peep).="" rescue="" therapies="" include="" prone="" position="" and="" neuromuscular="" blocking="" agents.="" extracorporeal="" support="" for="" decapneisation="" and="" oxygenation="" should="" only="" be="" considered="" when="" lung-protective="" ventilation="" is="" no="" longer="" possible,="" or="" in="" cases="" of="" refractory="" hypoxaemia,="" respectively.="" tracheotomy="" is="" only="" recommended="" when="" prolonged="" mechanical="" ventilation="" is=""> Of all tested pharmacological interventions for ARDS, only treatment with steroids is considered to have benefit. Proper identification of phenotypes, known to respond differently to specific interventions, is increasingly considered important for clinical trials of interventions for ARDS. Such phenotypes could be defined based on clinical parameters, such as the arterial oxygen tension/inspiratory oxygen fraction ratio, but biological marker profiles could be more promising. ...... 所以，我就不知天高地厚地做了一个幻灯片，为能在公众号中提供幻灯版，还要转化为图片，就是下面的内容：       |
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