CAJ | 학술논문

为探讨小儿心脏术后急性呼吸窘迫综合征(ARDS)的临床发病特点及治疗对策，对23例ARDS患儿(包括早期发病8例、迟发15例)采用：①限制吸气峰压≤35cmH2O(3.43kPa)；②早期应用呼气末正压(PEEP)8～12cmH2O(0.78～1.18kPa)；③反复性侧卧体位等措施。结果23例中1例(1/23)继发感染、急性肾功能衰竭死亡；并发气胸2例(2/23)；严重肺不张3例(3/23)；痰培养阳性5例(5/23)。结果显示：对ARDS高危患儿应慎重选择早期拔管指征；对诊断明确者应用低容量限压通气配合体位变换可减少并发症、提高治愈率。
위탐토소인심장술후급성호흡군박종합정(ARDS)적림상발병특점급치료대책，대23례ARDS환인(포괄조기발병8례、지발15례)채용：①한제흡기봉압≤35cmH2O(3.43kPa)；②조기응용호기말정압(PEEP)8～12cmH2O(0.78～1.18kPa)；③반복성측와체위등조시。결과23례중1례(1/23)계발감염、급성신공능쇠갈사망；병발기흉2례(2/23)；엄중폐불장3례(3/23)；담배양양성5례(5/23)。결과현시：대ARDS고위환인응신중선택조기발관지정；대진단명학자응용저용량한압통기배합체위변환가감소병발증、제고치유솔。
To sum up the clinical course and treatment strategy of pediatricpatients with acute respiratory, distress syndrome (ARDS) after open heart surgery, we studied 23 pediatric ARDS patients including early episode in 8 cases and late episode in 15 cases. The maneuvers we performed were as follow:①Applying low peak inspiratory pressure ≤35 cm H2O; ②Using PEEP 8～12 cm H2O in the early period; ③Repeated lateral positioning.Results:1 case (1/23) died because of infection and acute renal failure, 2 cases (2/23) complicated with pneumothorax, 3 cases (3/23) with serious atelectasis and 5 cases (5/23) with positive sputum culture. Conclusion : We consider that choosing early extubation with discretion and applying low-volume pressure-limited ventilation combined with repeated lateral positioning can lower the Complications and mortality in the treatment of ARDS.