Advances in right ventricular protective ventilatory strategy for acute respiratory distress syndrome / 中国小儿急救医学

ABSTRACT

Acute respiratory distress syndrome ( ARDS) is a devastating clinical syndrome with the condition of dyspnea,characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema. Current therapeutic strategies are based on improving oxygenation and pulmonary compliance while minimizing ventilator-induced lung injury. However,many previous studies had found that the leading risk of ARDS patient′s death is circulatory collapse rather than pulmonary injury or hypoxemia. Additionally,acute cardiac dysfunc-tion caused by increased pulmonary vascular resistance is an important cause of circulatory failure. Besides,with the deepening of the studies,the dysfunction of lung and heart in ARDS patients,also known as severe acute cor pulmonale (ACP),has been shown to be associated with the pathophysiological process of the ARDS and could lead to the increase of right ventricular pressure load,which eventually might result in right ventricular failure. Furthermore,the inappropriate mechanical ventilation could also lead to right ventricular failure,and therefore it′s necessary to closely monitor the function of right ventricular in ARDS patients. To conclude,we will intro-duce the protective ventilation strategy of right ventricular preliminarily in this review.