Acute Lung Injury: Epidemiology, Pathogenesis, and Treatment

作者：Johnson Elizabeth R; Matthay Michael A^*

来源：Journal of Aerosol Medicine and Pulmonary Drug Delivery, 2010, 23(4): 243-252.

DOI：10.1089/jamp.2009.0775

• acute respiratory distress syndrome (ARDS)
• pulmonary edema
• acute respiratory failure

Acute lung injury (ALI) remains a significant source of morbidity and mortality in the critically ill patient population. Defined by a constellation of clinical criteria (acute onset of bilateral pulmonary infiltrates with hypoxemia without evidence of hydrostatic pulmonary edema), ALI has a high incidence (200,000 per year in the US) and overall mortality remains high. Pathogenesis of ALI is explained by injury to both the vascular endothelium and alveolar epithelium. Recent advances in the understanding of pathophysiology have identified several biologic markers that are associated with worse clinical outcomes. Phase III clinical trials by the NHLBI ARDS Network have resulted in improvement in survival and a reduction in the duration of mechanical ventilation with a lung-protective ventilation strategy and fluid conservative protocol. Potential areas of future treatments include nutritional strategies, statin therapy, and mesenchymal stem cells.

• 出版日期2010-8