Definition, Pathophysiologie und Epidemiologie des akuten Lungenversagens

Intensivmedizin und Notfallmedizin - Tập 36 - Trang S022-S025 - 1999
K. Lewandowski1, H. Lohbrunner1
1Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Charité, Medizinische Fakultät d. Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, e-mail: [email protected], , DE

Tóm tắt

The American-European Consensus Conference recently recommended the following criteria for diagnosis of ARDS: (1) acute onset; (2) PaO2/FiO2≤200 mmHg regardless of PEEP level; (3) bilateral infiltrates seen on frontal chest radiograph; (4) PCWP ≤ 18 mmHg when measured or no clinical evidence of left atrial hypertension. Pathophysiologically, ARDS is characterized by pulmonary edema owing to injury of the capillary-alveolar membranes and increased pulmonary artery pressure. It is further distinguished by severe hypoxemia unresponsive to the usual methods of support for respiratory failure. Hypoxemia is caused by intrapulmonary right-to-left shunting due to to persistent perfusion of non-ventilated alveoli. Another characteristic feature in ARDS is the low thoracopulmonary compliance. Latest studies suggest that the incidence of the syndrome is in the range of 3–10 cases / 100,000 inhabitants / year. Mortality rates are a major concern: old and new reports continue to report mortality rates of 50–60%.