文章来源：免疫炎症事业部中央市场部

摘要信息：引发重症肺炎/低氧/ARDS的核心关键词：肾移植术后、胆囊炎、全身炎症反应、移植肾功能不全；腹腔镜胰头十二指肠切除术、术后、老年、梗阻性黄疸；脑梗取栓、人鼻病毒、肺炎克雷伯菌、吸入性、急性呼吸窘迫综合征

文章来源：免疫炎症事业部中央市场部

摘要信息：2025年新增科室会幻灯、希为纳VS乌司他丁

文章来源：PubMed

摘要信息：Background. Since the 2012 Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS), several developments have supported the need for an expansion of the definition, including the use of high flow nasal oxygen (HFNO), expanding use of pulse oximetry in place of arterial blood gases, use of ultrasound for chest imaging, and the need for applicability in resource-limited settings. Methods. A Consensus Conference of 32 critical care ARDS experts was convened, had six virtual meetings (June 2021-March 2022), and subsequently obtained input from members of several critical care societies. The goal was to develop a definition that would: (1) identify patients with the currently accepted conceptual framework for ARDS; (2) facilitate rapid ARDS diagnosis for clinical care and research; (3) be applicable in resource-limited settings; (4) be useful for testing specific therapies; and (5) be practical for communication to patients and caregivers. Results. The committee made four main recommendations: (1) Include HFNO with a minimum flow rate of  30 liters/min; (2) Use arterial oxygen tension (PaO2)/FiO2  300 mmHg or SpO2/FiO2 < 315 (if SpO2  97%) to identify hypoxemia; (3) Retain bilateral opacities for imaging criteria but add ultrasound as an imaging modality, especially in resource-limited areas; and (4) In resource-limited settings, do not require PEEP, oxygen flow rate, or specific respiratory support devices. Conclusions. We propose a New Global Definition of ARDS that builds on the Berlin Definition. The recommendations also identify areas for future research, including the need for prospective assessments of feasibility, reliability, and prognostic validity of the proposed Global Definition.

文章来源：PubMed

摘要信息：Objective:We aimed to evaluate the protective effects of sivelestat sodium on the basis of corticosteroid therapy in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).Methods:We retrospectively investigated 127 patients with confirmed moderate-to-severe ARDS treated in the intensive care unit (ICU) at Dazhou Central Hospital. Patients were divided into the control group (corticosteroids alone) and the combination therapy of steroids and sivelestat sodium (CTSSS) group according to the therapeutic interventions. The primary outcome was in-hospital mortality. And the baseline characteristics and laboratory findings of patients were collected for analysis.Results:The overall mortality rate in 127 patients was 48.8%. There was no statistically significant difference in in-hospital mortality between the CTSSS group and the control group (45.3% vs. 56.1%). In the subgroup of patients aged < 80 years or with an Acute Physiology and Chronic Health Evaluation (APACHE) II score < 30, CTSSS could reduce the risk of mortality (odds ratio [OR] = 0.41, 95% confidence interval [CI], 0.17-0.96, p=0.041; OR = 0.31, 95% CI, 0.13-0.77, p=0.012; respectively). Among patients aged 80 years or older, those with CTSSS exhibited a significantly elevated risk of mortality (OR = 13; 95% CI, 1.20-140.73; p=0.035).Conclusion:Compared with corticosteroids alone, CTSSS could improve oxygenation index, increase lymphocyte count, protect extrapulmonary organs and reduce in-hospital mortality rate in patients with moderate-to-severe ARDS in specific subgroups (age < 80 years or APACHE II score < 30). It might be advisable to avoid CTSSS in moderate-to-severe ARDS patients aged 80 years or older. Prospective studies involving larger sample sizes are needed to verify these findings.

文章来源：中国知网

摘要信息：目的：探讨西维来司他钠联合气道压力释放通气（APRV）治疗小儿重度急性呼吸窘迫综合征（ARDS）的临床效果。方法：前瞻性选取2021年5月至2023年5月该院收治的重度ARDS患儿102例，按照随机数字表法分为对照组和研究组，各51例。对照组患儿给予APRV+基础对症治疗，研究组患儿给予西维来司他钠+APRV+基础对症治疗。比较两组患儿的临床症状体征、临床疗效和并发症发生率，治疗前后的肺功能指标、动脉血气指标和炎症因子水平。结果：研究组患儿的总有效率为94.12%（48/51）,明显高于对照组的80.39%（41/51）,差异有统计学意义（P<0.05）。研究组患儿机械通气时间、气促消失时间、肺部啰音消失时间和住院时间较对照组缩短，差异均有统计学意义（P<0.05）。治疗3、7 d后，两组患儿的血氧分压（PaO2）、动脉血氧饱和度（SaO2）高于治疗前，血二氧化碳分压（PaCO2）低于治疗前；且研究组患儿PaO2、SaO2和PaCO2的变化幅度大于对照组，差异均有统计学意义（P<0.05）。治疗3、7 d后，两组患儿的最大呼气压、最大呼气流量、最大吸气压和最大呼气中段流量较治疗前升高，且研究组患儿高于对照组；治疗3、7 d后，两组患儿血清C反应蛋白、肿瘤坏死因子α、巨噬细胞移动抑制因子-1和白细胞介素6水平较治疗前降低，且研究组患儿低于对照组，差异均有统计学意义（P<0.05）。研究组患儿的并发症发生率为5.88%（3/51）,低于对照组的21.57%（11/51）,差异有统计学意义（P<0.05）。结论：西维来司他钠联合APRV治疗小儿重度ARDS的疗效显著，能有效抑制患儿血清炎症因子释放，改善患儿血气分析指标、临床症状和肺功能，且能减少并发症的发生。

文章来源：中国知网

摘要信息：目的 观察西维来司他钠在ICU不同疾病合并急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法 回顾性选择2021年7月—2023年6月华侨大学附属厦门长庚医院ICU不同疾病合并ARDS患者87例，根据疾病类型不同分为肺炎组(n=37)、创伤组(n=21)和胰腺炎组(n=29)。所有患者均给予常规方法治疗，并于肺损伤发生后72 h内使用西维来司他钠治疗，3组均治疗7 d。比较3组呼吸功能、炎性指标及疾病转归情况。结果 干预7 d后，3组呼吸频率低于干预前(P<0.01);肺炎组与创伤组经皮血氧饱和度及3组氧合指数高于干预前(P<0.01),胰腺炎组经皮血氧饱和度干预前后比较无统计学差异(P>0.05);3组白细胞计数、中性粒细胞百分比、降钙素原、C反应蛋白水平低于干预前(P<0.01);肺炎组痊愈出院率为83.78%,创伤组痊愈出院率为90.48%,胰腺炎组痊愈出院率为89.66%。结论 西维来司他钠用于ICU不同疾病合并ARDS患者治疗中均可获得良好效果，可改善患者呼吸功能，降低炎性指标水平，有助于改善患者疾病转归。

文章来源：免疫炎症事业部中央市场部

文章来源：免疫炎症事业部中央市场部

文章来源：免疫炎症事业部中央市场部

文章来源：中国知网

摘要信息：目的：探讨创伤所致重度急性呼吸窘迫综合征（ARDS）行气道压力释放通气联合西维来司他钠治疗的 效果和对患者炎症因子的影响。方法：回顾性选取 2022 年 1 月至 2024 年 2 月湛江中心人民医院重症医学科收治的创 伤所致重度 ARDS 患者 98 例，依据治疗方法的不同分为通气治疗组（气道压力释放通气治疗）、联合药物组（气道 压力释放通气联合西维来司他钠治疗），各 49 例。比较两组患者临床疗效、炎症因子水平、血流动力学指标、临床 指标、不良反应发生情况。结果：联合药物组患者临床总有效率高于通气治疗组，差异具有统计学意义（P ＜ 0.05）。 治疗后，联合药物组患者血清肿瘤坏死因子 –α（TNF–α）、C 反应蛋白（CRP）、白细胞介素（IL）–6、IL–10 水平 低于通气治疗组，差异具有统计学意义（P ＜ 0.05）。治疗后各时间点，两组患者心率（HR）、中心静脉压（CVP）、 平均动脉压（MAP）比较，差异无统计学意义（P ＞ 0.05）。联合药物组患者氧疗时间、通气时间和住院时间短于通 气治疗组，差异具有统计学意义（P ＜ 0.05）。两组患者不良反应发生率比较，差异无统计学意义（P ＞ 0.05）。结论： 创伤所致重度 ARDS 气道压力释放通气联合西维来司他钠治疗的疗效较单独气道压力释放通气治疗显著，更能降低 患者的炎症因子水平。