李旭;马晓春;
LI Xu;MA Xiao-chun;Department of Critical Care Medicine,the First Affiliated Hospital of China Medical University;

• 1:中国医科大学附属第一医院重症医学科

摘要(Abstract)：

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在全球暴发流行,危害严重。虽然目前临床研究和尸检结果提高了人们对COVID-19的认识,但仍存在诸多争议,最大的争议之一即为重症COVID-19是否可诊断为急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)。重症COVID-19符合ARDS柏林标准,但与其他原因导致的ARDS存在诸多不同之处,包括发病晚、部分患者肺顺应性相对正常、高碳酸血症出现较早、肺CT表现和肺凝血活化明显。目前对COVID-19相关ARDS的分型多基于观察性研究,偏倚较大。至今其病理生理过程尚未明确,过早分型可能误导机械通气策略,期待大样本临床研究结果带来更多证据。
The outbreak of coronavirus disease 2019(COVID-19)poses a major global threat. Although we have learned a lot about COVID-19 from clinical studies and autopsy findings, there is still a lot of confusion. One of the biggest controversies is whether severe COVID-19 can be diagnosed as acute respiratory distress syndrome(ARDS). Severe COVID-19 may meet ARDS Berlin criteria, but it differs from ARDS caused by other etiologies and is characterized by later onset time, relatively normal lung compliance in some cases, significant hypercapnia, lung CT findings, and significant coagulation activation in lungs. Some reports classify COVID-19-related ARDS into different phenotypes, but most of them are based on observational studies, with high bias. To date, we have not fully understood the pathophysiology of COVID-19-related ARDS. Premature phenotyping may mislead mechanical ventilation strategies. We expect evidence from large clinical studies.

关键词(KeyWords)： 新型冠状病毒;新型冠状病毒肺炎;急性呼吸窘迫综合征;柏林标准
SARS-CoV-2;coronavirus disease 2019;acute respiratory distress syndrome;Berlin criteria

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 李旭;马晓春;
LI Xu;MA Xiao-chun;Department of Critical Care Medicine,the First Affiliated Hospital of China Medical University;

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