アブストラクト
| Title | ARDS |
|---|---|
| Subtitle | 特集 ICUとCCUでよくみられる病態・疾患 - 標準的な診断・治療・管理2020 - |
| Authors | 黒田浩光*1, 升田好樹*1 |
| Authors (kana) | |
| Organization | *1札幌医科大学医学部集中治療医学 |
| Journal | ICUとCCU |
| Volume | 44 |
| Number | 4 |
| Page | 171-178 |
| Year/Month | 2020 / 4 |
| Article | 報告 |
| Publisher | 医学図書出版 |
| Abstract | 「要約」ARDSはさまざまな生体侵襲に対する続発症であるため, 原因の除去と酸素化障害の原因と肺傷害を評価することが治療の第一歩である. ARDSの診断基準自体が病態を正確に表現しているわけではないと指摘されている. そのため, 画一的にARDSの治療法をあてはめることでさまざまなRCTが失敗したことから分かるように, ARDSの治療成績向上には, より精緻な病態評価が必要と考えられている. 現状では酸素化障害や肺傷害を評価する方法として胸部CTが望ましいと考える. われわれの施設では胸部CT所見に基づいて背側consolidationが主体であれば長時間腹臥位を行い, スリガラス様陰影が主体であればメチルプレドニゾロン投与している. また患者の吸気努力が強い場合には非脱分極性筋弛緩薬投与や, PaO2/FlO2 < 80の高度な酸素化障害では体外式膜型人工肺を用いる方針としている. |
| Practice | 臨床医学：一般 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に1,023円(税込) です。
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