ICU治疗策略的新进展

New Development of Treatment Strategy in ICU

在过去的5年中,重症医学领域的许多新试验已经改变了传统的治疗策略。在这个领域的许多方面,出现了令人惊喜的成就,如脓毒性休克和急性呼吸窘迫综合征(ARDS)的治疗,以及重症患者的支持治疗(镇静、胰岛素)。值得注意的是,在这些试验中,一些传统的治疗措施被证明是失败的,如肺动脉导管在ARDS患者中的应用并不能改善ARDS患者的预后。该文总结8项主要的试验,以帮助研究者寻找更好的治疗方法。

In the last 5 years, many new trials have changed the traditional treatment strategy in the field of critical care medicine. Many surprising achievements appeared in many aspects of the field, such as the treatment for septic shock and acute respiratory distress syndrome（ARDS） ,as well as supportive therapies for critical patients（ sedatives and insulin）. It is notable that some of the traditional treatment measures proved to be frustrated in these trials. For example, recent studies showed that a pulmonary arterial catheter did not improvethe prognosis of the patients with ARDS. In this review, eight major trials in critical care medicine will be summarized in order to held researchers to search for better therapeutic measures.