Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya31664Editorial articleПередовая статьяReview ArticleAcute respiratory distress syndrome: How to optimize oxygen transport and to improve prognosisОстрый респираторный дистресс-синдром: пути оптимизации транспорта кислорода и улучшения прогнозаShtabnitskiĭV AШтабницкийВ Аvashtab@rambler.ruChuchalinA GЧучалинА ГФГБУ "НИИ пульмонологии" ФМБА России, Москва151120148611VOL 86, NO11 (2014)ТОМ 86, №11 (2014)11512210042020Copyright ©; 2014, Consilium MedicumCopyright ©; 2014, ООО "Консилиум Медикум"2014Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/31664

The paper reviews the state-of-the-art of acute respiratory distress syndrome (ARDS) and current approaches to correcting respiratory failure. It highlights the historical and present-day data on the efficiency of extracorporeal membrane hemoxygenation, high-frequency ventilation, surfactant and inhaled nitric oxide therapy, and prone ventilation. The examinations have shown that ventilation in the prone position and extracorporeal membrane hemoxygenation not only improve gas exchange, but have a positive prognostic impact. The use of inhaled nitric oxide and surfactant achieves improved oxygenation for a while, but has no substantial effect on prognosis. The place of high-frequency oscillatory ventilation in the treatment of patients with ARDS has not been fully determined as some examinations have indicated a positive prognostic impact and other examinations have shown none or a negative impact.

Аннотация. В статье представлен обзор современного состояния проблемы острого респираторного дистресс-синдрома (ОРДС) и современных подходов к коррекции дыхательной недостаточности. Освещены исторические и современные данные по эффективности применения экстракорпоральной мембранной гемооксигенации, высокочастотной вентиляции легких, терапии сурфактантом и ингаляционным оксидом азота, а также искусственной вентиляции в "прональной позиции". Согласно результатам проведенных исследований вентиляция в положении на животе и экстракорпоральная мембранная гемооксигенация не только улучшают показатели газообмена, но и положительно влияют на прогноз. Использование ингаляционного оксида азота и сурфактанта позволяет на некоторое время добиться улучшения оксигенации, но не оказывает существенного влияния на прогноз. Место высокочастотной осцилляторной вентиляции легких в лечении больных с ОРДС не до конца определено, так как часть исследований показала положительное влияние на прогноз, а в других эффект не продемонстрирован или был отрицательный.

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