{"id":23178,"date":"2023-02-24T04:25:00","date_gmt":"2023-02-23T20:25:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23178"},"modified":"2023-02-24T09:31:40","modified_gmt":"2023-02-24T01:31:40","slug":"lancet-respir-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97%e6%9c%ba%e6%a2%b0%e9%80%9a%e6%b0%94%e7%9a%84%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e7%9b%b8%e5%85%b3ards%e6%82%a3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23178","title":{"rendered":"[Lancet Respir Med\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7\u673a\u68b0\u901a\u6c14\u7684\u65b0\u51a0\u80ba\u708e\u76f8\u5173ARDS\u60a3\u8005\u7684\u547c\u5438\u529b\u5b66\u3001\u6c14\u4f53\u4ea4\u6362\u548c\u9884\u540e"},"content":{"rendered":"\n<p>REVIEW|<a href=\"https:\/\/www.thelancet.com\/journals\/lanres\/issue\/vol10no12\/PIIS2213-2600(22)X0012-X\">&nbsp;VOLUME 10, ISSUE 12<\/a>,&nbsp;P1178-1188,&nbsp;DECEMBER 01, 2022<\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Respiratory system mechanics, gas exchange, and outcomes in mechanically ventilated patients with COVID-19-related acute respiratory distress syndrome: a systematic review and meta-analysis<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Mallikarjuna Ponnapa Reddy, <span style=\"background-color: rgba(0, 0, 0, 0.2); font-size: revert; font-weight: revert;\">Ashwin Subramaniam, Clara ChuaRyan Ruiyang Ling\u00a0et al.<\/span><\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Lancet Respir Med 2022; 10: 1178-1188 Published:November 03, 2022<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">DOI:<a href=\"https:\/\/doi.org\/10.1016\/S2213-2600(22)00393-9\">https:\/\/doi.org\/10.1016\/S2213-2600(22)00393-9<\/a><\/h3>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"seccestitle10\">Summary<\/h2>\n\n\n\n<p>The association of respiratory mechanics, particularly respiratory system static compliance (C<sub>RS<\/sub>), with severity of hypoxaemia in patients with COVID-19-related acute respiratory distress syndrome (ARDS) has been widely debated, with some studies reporting distinct ARDS phenotypes based on C<sub>RS<\/sub>. Ascertaining whether such phenotypes exist is important, because they might indicate the need for ventilation strategies that differ from those used in patients with ARDS due to other causes. In a systematic review and meta-analysis of studies published between Dec 1, 2019, and March 14, 2022, we evaluated respiratory system mechanics, ventilator parameters, gas exchange parameters, and clinical outcomes in patients with COVID-19-related ARDS. Among 11\u2008356 patients in 37 studies, mean reported C<sub>RS<\/sub>, measured close to the time of endotracheal intubation, was 35\u00b78 mL\/cm H<sub>2<\/sub>O (95% CI 33\u00b79\u201337\u00b78;\u00a0<em>I<\/em><sup>2<\/sup>=96\u00b79%, \u03c4<sup>2<\/sup>=32\u00b76). Pooled mean C<sub>RS<\/sub>\u00a0was normally distributed. Increasing ARDS severity (assessed by PaO<sub>2<\/sub>\/FiO<sub>2<\/sub>\u00a0ratio as mild, moderate, or severe) was associated with decreasing C<sub>RS<\/sub>. We found no evidence for distinct C<sub>RS<\/sub>-based clinical phenotypes in patients with COVID-19-related ARDS, and we therefore conclude that no change in conventional lung-protective ventilation strategies is warranted. Future studies should explore the personalisation of mechanical ventilation strategies according to factors including respiratory system mechanics and haemodynamic status in patients with ARDS.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.thelancet.com\/cms\/attachment\/6852a4b0-1b39-4edb-99cf-f82c39725671\/gr1.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.thelancet.com\/cms\/attachment\/e2b6c856-a628-4272-802e-61944b445821\/gr2.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.thelancet.com\/cms\/attachment\/7828f68b-fcbf-4d97-a8a1-6c1dca630166\/gr3.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.thelancet.com\/cms\/attachment\/32c28d86-e966-4294-af4c-bc3c0eaf47cb\/gr4.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.thelancet.com\/cms\/attachment\/be7e8a51-2143-4f89-bbe9-edd2fe4a80df\/gr5.jpg\" alt=\"\"\/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>REVIEW|&nbsp;VOLUME 10, ISSUE 12,&nbsp;P1178-1188,&#038;nbsp [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23178"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23178"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23178\/revisions"}],"predecessor-version":[{"id":23179,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23178\/revisions\/23179"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23178"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23178"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}