護理師照護一位急性呼吸窘迫症候群(ARDS)病人,治療的主要目標為何?
A nurse is monitoring a client with acute respiratory distress syndrome (ARDS). What is the main goal of therapy?
- AIncrease cardiac output增加心輸出量
- BReduce fluid intake減少液體攝取
- CManage anxiety管理焦慮
- DMaintain oxygenation✓ 正解維持氧合
急性呼吸窘迫症候群(ARDS)的核心病理生理機制為瀰漫性肺泡損傷,導致肺部微血管通透性增加,引起非心因性肺水腫及嚴重的頑固性低血氧。臨床治療的首要目標是維持組織氧合,通常透過機械通氣配合呼氣末正壓(PEEP)來復張塌陷的肺泡。此病症死亡率極高,低血氧引發的器官衰竭是主要死因,因此優先處理氧合問題是護理照護的重中之重。
The primary pathophysiological issue in ARDS is diffuse alveolar damage leading to noncardiogenic pulmonary edema and severe, refractory hypoxemia. Consequently, the main goal of therapy is to maintain adequate tissue oxygenation, typically achieved through mechanical ventilation with positive end-expiratory pressure (PEEP) to recruit collapsed alveoli.
在美國臨床環境中,ARDS 的機械通氣策略強調「肺保護通氣策略(Lung Protective Ventilation Strategy)」,包括低潮氣量(Low Tidal Volume)和適當的 PEEP 設定,以減少呼吸機相關性肺損傷(VALI)。