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1、ARDS臨床流行病調(diào)查 2.肺表面活性物質(zhì)/吸入NO治療ALI/ARDS孫波復(fù)旦大學兒科醫(yī)院ClinicalEpidemiologyofARDSinChinaSurfactantandiNOinTreatmentofARDSBoSun,MD,PhDChildren’sHospitalofFudanUniversity2005-03-19BeijingClinicalepidemiologyofALI/ARDSIncidenceofrespiratoryfailure,mechanicalventilation,andALI/ARDSinI
2、CUStandarddiagnosisandcaremanagementClinicaltrial,controlandinterventionFollowupoutcomesAssesscost-effectivenessMedicalresources,network上海市醫(yī)院急性呼吸窘迫綜合征臨床發(fā)病情況調(diào)查A12-MonthSurveyofARDSinAdultICUsShanghaiARDSStudyGroupIntensiveCareMed2004;30(12):2197-2203Morbidity15PICUs,5320ad
3、missions/2001-2002(12mon)108ARDS(2%ofadmission)(Europe6-7%)>15yearsold>24hofadmission,<7daysofprimaryinsult1994AECC:ARDSPaO2/FiO2(mmHg)111+40APACHEII17.3+8LIS>2.5(n)33IntensiveCareMed2004;30(12):2197-2203MortalityDeath:74(68.5%)in-hospital76(70.4%)at3monthsafteronsetDeath
4、rate(病死率)ICUtotaldeath548/5320(10.3%)ARDS/ICUtotaldeath74/548(13.5%)ARDS:non-ARDS6.4:1(RR)IntensiveCareMed2004;30(12):2197-2203PredisposingfactorsofARDSDeathPulmonaryorigin41(39%)32-Pneumonia37(34.3%)29Non-pulmonary67(61%)42-Sepsis33(30.6%)MODS44/74(60%)Respiratoryfailure
5、17/74(23%)Septicshock9/74(12%)IntensiveCareMed2004;30(12):2197-2203PediatricARDSA12-monthsurveyofincidence,managementandoutcomeofARDSin25pediatricICUinChinaChinesePediatricARDSStudyGroupATS2005SanDiegoInt’lConference北京兒童醫(yī)院首都兒研所兒童醫(yī)院北京大學第一醫(yī)院哈爾濱兒童醫(yī)院中國醫(yī)科大學第二醫(yī)院河北醫(yī)科大學第二醫(yī)院天津兒童醫(yī)院
6、山西省兒童醫(yī)院鄭州兒童醫(yī)院重慶醫(yī)科大學兒童醫(yī)院廣州兒童醫(yī)院湖南省兒童醫(yī)院長春市兒童醫(yī)院深圳兒童醫(yī)院成都市兒童醫(yī)院泉州兒童醫(yī)院江西省兒童醫(yī)院浙江大學兒童醫(yī)院溫州育英兒童醫(yī)院南京兒童醫(yī)院蘇州兒童醫(yī)院上海兒童醫(yī)學中心上海新華醫(yī)院上海兒童醫(yī)院復(fù)旦大學兒科醫(yī)院小兒ARDS協(xié)作組PICUalladmissionsCriticalALI/ARDSSurvivaldeathPIM+Guide1994AECCTreatment基本流程25PediatricICU2004.01-12PICUtotal11453Critical6839RF呼吸衰竭1862MV
7、1883ALI303ARDS97ResultsIncidence/PICUadmissionARDS患病率1.42%ALI患病率4.4%DeathrateARDS病死率62.9%(61)TotalPICU6.8%RRARDS:non-ARDS8.3:1Cost:ARDS/non-ARDS4.5:1PredisposingfactorsofpediatricARDSPneumonia40Sepsis14Immunocompromised15Intoxication8Post-operation4Trauma4Asphyxia3Others1
8、1MeasurementtoreducemortalityEarlydiagnosisandmanagementVentilation:lowtidalvolumeSpecifictherap
