2023急性呼吸窘迫综合征全球新标准:进步与局限

New 2023 global definition of acute respiratory distress syndrome:progress and limitation

急性呼吸窘迫综合征(ARDS)作为一种临床综合征,缺乏诊断金标准。虽然五十五年来ARDS的定义进行了多次修订,但随着临床实践和科学研究的进展,“柏林标准”的局限性日渐突出。为了应对这些改变,2023 ARDS全球新标准扩展了诊断对象、胸部影像学和低氧评估手段并增加了资源受限地区的诊断,以此促进了ARDS早期识别与治疗干预、流行病学以及临床相关研究的开展。但是,这种“广义”水平的修订可能涵盖非ARDS的患者人群,增加ARDS诊断的假阳性率。因此,2023 ARDS全球新标准的有效性和准确性需要进一步验证。

Acute respiratory distress syndrome(ARDS)presents a challenge in clinical diagnosis as it lacks a definitive gold standard.Over the past 55 years,there have been several revisions to the definition of ARDS.With the progress of clinical practice and scientific research,the limitations of the"Berlin definition"have become increasingly evident.In response to these changes,the 2023 global definition of ARDS aims to address these issues by expanding the diagnostic targets,chest imaging,and methods for assessing hypoxia.Additionally,the new definition increases the diagnostic criteria to accommodate resource-constrained settings.The expansion facilitates early identification and treatment interventions for ARDS,thereby advancing epidemiological and clinically related research.Nevertheless,the broad nature of this revision may include patients who do not actually have ARDS,thus raising the risk of false-positive diagnoses.Therefore,additional verification is crucial to ascertain the validity and accuracy of the 2023 global definition of ARDS.