Acute respiratory distress syndrome and lung injury: Pathogenetic mechanism and therapeutic implication

查看全文 作　　者：Chain-Fa [1]Su;Shang Jyh [2,3]Kao;Hsing I [4]Chen

机构地区：[1]Department of Neurosurgery, Tzu Chi University Hospital;[2]Division of Chest Medicine,Department of Internal Medicine,Shin-Kong Wu Ho-Su Memorial Hospital;[3]School of Respiratory Therapy, Taipei Medical University;[4]Institute of Physiological and Anatomical Medicine,Tzu Chi University

出　　处：《World Journal of Critical Care Medicine》索引2012年第1卷第2期,共11页

基　　金：Supported by Grants from the National Science Council,Far Eastern Medical Foundation;Tzu Chi Charitable Foundation 摘　　要：To review possible mechanisms and therapeutics for acute lung injury(ALI) and acute respiratory distress syndrome(ARDS). ALI/ARDS causes high mortality. The risk factors include head injury, intracranial disorders, sepsis, infections and others. Investigations have indicated the detrimental role of nitric oxide(NO) through the inducible NO synthase(i NOS). The possible therapeutic regimen includes extracorporeal membrane oxygenation, prone position, fluid and hemodynamic management and permissive hypercapnic acidosis etc. Other pharmacological treatments are anti-inflammatory and/or antimicrobial agents, inhalation of NO, glucocorticoids, surfactant therapy and agents facilitating lung water resolution and ion transports. β-adrenergic agonists are able to accelerate lung fluid and ion removal and to stimulate surfactant secretion. In con-scious rats, regular exercise training alleviates the endotoxin-induced ALI. Propofol and N-acetylcysteine exert protective effect on the ALI induced by endotoxin. Insulin possesses anti-inflammatory effect. Pentobarbital is capable of reducing the endotoxin-induced ALI. In addition, nicotinamide or niacinamide abrogates the ALI caused by ischemia/reperfusion or endotoxemia. This review includes historical retrospective of ALI/ARDS, the neurogenic pulmonary edema due to head injury, the detrimental role of NO, the risk factors, and the possible pathogenetic mechanisms as well as therapeutic regimen for ALI/ARDS. 关键词：ACUTE lung injury ACUTE respiratory distress syndrome Pathogenetic mechanisms Therapeutic REGIMEN NITRIC OXIDE INDUCIBLE NITRIC OXIDE synthase

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Acute respiratory distress syndrome and lung injury: Pathogenetic mechanism and therapeutic implication

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