急性呼吸窘迫综合征患者俯卧位通气治疗规范化流程

中华内科杂志2020年10月第59卷第10期Chin J Intem Med..0 ctober2020.Val.59,Na.10·781·标准与讨论急性呼吸窘迫综合征患者俯卧位通气治疗规范化流程中华医学会重症医学分会重症呼吸学组通信作者：刘玲，东南大学附属中大医院重症医学科，南京210009，Email:liulingdoctor(@126.com;徐磊，天津市第三中心医院重症医学科300170，Email:nokial007008@163.com【提要】俯卧位通气是中、重度急性呼吸窘迫综合征(ARDS)患者重要的治疗措施之一，可有效改善患者氧合，降低病死率。但我国重症医学医疗资源分布极不均衡，俯卧位通气治疗依从性不高且缺乏规范化的治疗流程。中华医学会重症医学分会重症呼吸学组制定了ARDS患者俯卧位通气治疗的规范化流程，旨在促进ARDS患者俯卧位通气规范化实施与管理，推动俯卧位通气治疗的同质化。【关键词】急性呼吸窘迫综合征：俯卧位通气：规范：并发症Standardized protocol of prone position ventilation in patients with acute respiratorydistress syndromeSubgroup of Critical Respiratory Diseases,Chinese Society of Critical Care Medicine,Chinese MedicalAssociationCorresponding author:Liu Ling,Department of Critical Care Medicine,Zhongda Hospital,School ofMedicine,Southeast University,Nanjing 210009,China,Email liulingdoctor@126.com;Xu Lei,Department of Critical Care Medicine,Tianjin Third Central Hospital,Tianjin 300170,China,Email:nokia007008@163.comSummary Prone position ventilation (PPV)is an effective treatment for patients withmoderate/sever acute respiratory distress syndrome (ARDS),which can improve oxygenation andreduce mortality.Due to the uneven distribution of medical resources in China,the compliance ofPPV is quite low.Standardized protocol of PPV is still unavailable in lots of intensive care units.Subgroup of Critical Respiratory Diseases,Chinese Society of Critical Care Medicine,Chinese MedicalAssociation established a standardized protocoL The aim of the present protocol is to improve thestandardized application of PPV in China.Key words Acute respiratory distress syndrome;Prone position ventilation;Benchmarking:Complications急性呼吸窘迫综合征(ARDS)是常见的重症疾具有改善氧合、改善高碳酸血症、利于肺保护性通病之一，其原发疾病多样、机制复杂、致病环节多，气策略的实施及改善右心功能等作用，并降低病死病死率高达409%-50%0。机械通气是救治ARDS率。但对全球50个国家ARDS诊治的调查发现，重患者的关键医疗措施，如何促进机械通气策略的实症ARDS患者接受俯卧位通气治疗的比例仅有施成为重点。随着对ARDS病理生理的认识，俯卧16.3%)。我国重症ARDS患者接受俯卧位通气治位通气治疗作为机械通气治疗的一个环节越来越疗的比例仅8.7%。目前我国重症医学医疗资源受重视。2017年欧洲重症医学会和美国胸科协会分布极不均衡，俯卧位通气治疗依从性不高且多缺强烈推荐严重ARDS患者行俯卧位通气治疗a,其乏规范化的实施流程。为此，中华医学会重症医学D0L:10.3760/cmaj.cm112138-20200430-00439收稿日期2020-04-30本文编辑胡朝晖引用本文：中华医学会重症医学分会重症呼吸学组.急性呼吸窘迫综合征患者俯卧位通气治疗规范化流程中华内科杂志，2020,5910)：781-787.D0L:10.3760 W/cma..j.cn112138-20200430-00439.