急性呼吸窘迫综合征
医学
呼吸生理学
低氧血症
重症监护医学
肺顺应性
急性呼吸窘迫
病因学
2019年冠状病毒病(COVID-19)
弥漫性肺泡损伤
呼吸系统
心脏病学
肺
疾病
内科学
传染病(医学专业)
作者
Rebecca L. Kummer,John J. Marini
摘要
Acute respiratory distress syndrome (ARDS) is a well-defined clinical entity characterized by the acute onset of diffuse pulmonary injury and hypoxemia not explained by fluid overload. The COVID-19 pandemic brought about an unprecedented volume of patients with ARDS and challenged our understanding and clinical approach to treatment of this clinical syndrome. Unique to COVID-19 ARDS is the disruption and dysregulation of the pulmonary vascular compartment caused by the SARS-CoV-2 virus, which is a significant cause of hypoxemia in these patients. As a result, gas exchange does not necessarily correlate with respiratory system compliance and mechanics in COVID-19 ARDS as it does with other etiologies. The purpose of this review is to relate the mechanics of COVID-19 ARDS to its underlying pathophysiologic mechanisms and outline the lessons we have learned in the management of this clinic syndrome.
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