ŽQ‰ÁŽ{݈ꗗ

‘½Ž{Ý‹¤“¯ŽŽŒ±“Á•ÊˆÏˆõ‰ï

ˆÏˆõ–¼ Š‘®
ˆÏˆõ’· ŠÛ“¡@“N –kŠC“¹‘åŠw•a‰@æi‹}«Šúˆã—ÃZƒ“ƒ^[
  ˆ¢•”@’qˆê ’}”gƒƒfƒBƒJƒ‹ƒZƒ“ƒ^[•a‰@‹~‹}f—ÉÈ
  ’r“c@Ol ’é‹ž‘åŠwˆãŠw•”‹~‹}ˆãŠw
  ŽËê@•q–¾ ‡“V“°‘åŠwˆãŠw•”•t‘®‡“V“°ˆã‰@ ‹~‹}‰È
  ãŽR@¹Žj “Æ—§s­–@l’nˆæˆã—Ë@”\„i‹@\’†‹ž•a‰@‹~‹}‰È
  ‘å—F@N—T “Œ‹žˆã‰ÈŽ•‰È‘åŠwˆãŽ•Šw‘‡Œ¤‹†‰È‹~‹}ЊQˆãŠw•ª–ì
  ‰ª–{@DŽi –k‹ãBŽs—§”ª”¦•a‰@ Á‰»ŠíEŠÌ‘Ÿ•aƒZƒ“ƒ^[AŠO‰È
  ¬‘q@—TŽi ‘åã‘åŠwˆãŠw•”•‘®•a‰@‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
  ‹vŽu–{@¬Ž÷ “Œ–k‘åŠw‘åŠw‰@ˆãŠwŒnŒ¤‹†‰ÈŠO‰È•a‘ÔŠwuÀ‹~‹}ˆãŠw•ª–ì
  ¬’J@õŽ¡ •ºŒÉˆã‰È‘åŠw‹~‹}EЊQˆãŠw
  âV“¡@‘å‘  –h‰qˆã‘å–h‰qˆãŠwŒ¤‹†ƒZƒ“ƒ^[ŠOŒ¤‹†•”–åA“¯‘å•a‰@‹~‹}•”
  ã–{@—Yˆê˜Y ²‰ê‘åŠwˆãŠw•”‹~‹}ˆãŠw
  ²X–Ø@~ˆê Œcœä‹`m‘åŠwˆãŠw•”‹~‹}ˆãŠw
  ’Å–ì@‘טa ìèˆã‰È‘åŠw‹~‹}ˆãŠw
  ”’Î@~ ‹T“c‘‡•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
  ”’Î@Uˆê˜Y ‰ï’Ã’†‰›•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
  “cŒF@´Œp ìèŽs—§ìè•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
  ’Mˆä@••F ˆÇ—Ñ‘åŠwˆãŠw•”‹~‹}ˆãŠw
  ’ß“c@—Ç‰î ŽRŒû‘åŠwˆãŠw•”•‘®•a‰@æi‹~‹}ˆã—ÃZƒ“ƒ^[
  ’†“c@F–¾ ç—t‘åŠw‘åŠw‰@ˆãŠwŒ¤‹†‰@‹~‹}W’†Ž¡—ÈãŠw
  ”‹Œ´@͉à ‘—§‘Ûˆã—ÃŒ¤‹†ƒZƒ“ƒ^[•a‰@‹~‹}‰È
  ˆê“ñŽO@‹œ ì‘åŠwˆãŠw•”•‘®•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
  “¡“‡@´‘¾˜Y Œcœä‹`m‘åŠwˆãŠw•”‘‡f—˳ˆçƒZƒ“ƒ^[
  “¡Œ©@‘ ‘åã•{—§‹}«ŠúE‘‡ˆã—ÃZƒ“ƒ^[‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
  ‘–ì@’q•F “ú–{ˆã‰È‘åŠw‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
  ^‹|@r•F ŽY‹Æˆã‰È‘åŠw‹~‹}ˆãŠwuÀ
  •ŽR@’¼Žu ˆ¤’mˆã‰È‘åŠw•‘®•a‰@‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
  …“‡@–õ–¾ ‚è‚ñ‚­‚¤‘‡ˆã—ÃZƒ“ƒ^[‘åã•{òB‹~–½‹~‹}ƒZƒ“ƒ^[
  ŽR‰º@“T—Y ‹v—¯•Ä‘åŠw•a‰@‚“x‹~–½‹~‹}ƒZƒ“ƒ^[

Œ¤‹†ŽQ‰ÁŽ{Ý ”sŒŒÇ ŠO ARDS Œ€ÇŒ^Š´õÇ

”sŒŒÇ

–ß‚é

ˆã—Ö@l˜ßŽR‰ï “c‰ª•a‰@
ŽOd‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
JAL“‡‘‡•a‰@
ŒF–{‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}E‘‡f—Õ”
”ªŒËŽs—§Žs–¯•a‰@
‘åãŽs—§‘‡ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\ЊQˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\“Ȗ؈ã—ÃZƒ“ƒ^[
•xŽR‘åŠw•‘®•a‰@ Šë‹@ŠÇ—ˆãŠw
“Œ‹ž’üM•a‰@
ŽD–yˆã‰È‘åŠw ‹~‹}ˆãŠwuÀ
‰ªŽR϶‰ï‘‡•a‰@
‘—§•a‰@‹@\‘åãˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ÂXŒ§—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‹ž“s–¯ˆã˜A’†‰›•a‰@
‹T“c‘‡•a‰@ ‹~–½‹~‹}‰È
“Œ‹žˆã‰È‘åŠw”ª‰¤Žqˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‡“V“°‘åŠwˆãŠw•”•‘®—û”n•a‰@ ‹~‹}EW’†Ž¡—ÉÈ
‘—§•a‰@‹@\–kŠC“¹ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
H“c‘åŠwˆãŠw•”•‘®•a‰@‹~‹}•”EW’†Ž¡—Õ”
ŽR—œ‘åŠwˆãŠw•”‹~‹}W’†Ž¡—ÈãŠwuÀ
L“‡Žs—§L“‡Žs–¯•a‰@ ‹~‹}‰È
‘O‹´Ô\Žš•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[ W’†Ž¡—ÉÈE‹~‹}‰È
’†“ª•a‰@
å‘äŽs—§•a‰@ ‹~–½‹~‹}•”
•xŽmdH‹ÆŒ’N•ÛŒ¯‘g‡ ‘¾“c‹L”O•a‰@
²‰êŒ§ˆã—ÃZƒ“ƒ^[ D¶ŠÙ ‹~–½‹~‹}ƒZƒ“ƒ^[
•Ÿ‰ª‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
Î쌧—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
’·è‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
‘åãŽs—§‘åŠw‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
“Œ‹žƒxƒCE‰YˆÀŽsìˆã—ÃZƒ“ƒ^[ ‹~‹}‰È
“ú–{Ô\ŽšŽÐˆã—ÃZƒ“ƒ^[
”Ñ’Ë•a‰@
ŽÐ‰ïˆã—Ö@l‹ßX‰ï ‹ßX•a‰@
“Œ–¼Œú–Ø•a‰@
‘—§•a‰@‹@\“ì˜a‰ÌŽRˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
•½’ËŽs–¯•a‰@
‘—§•a‰@‹@\å‘äˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ˆ¤•Q‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}•”
‰ªŽR‘åŠw•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
“¿ŽR’†‰›•a‰@ ‹~‹}‰È
•ŸŽRŽs–¯•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
é‹Êˆã‰È‘åŠw‘Ûˆã—ÃZƒ“ƒ^[
Ž ‰êˆã‰È‘åŠw ‹~‹}EW’†Ž¡—Õ”
“ú–{‘åŠwˆãŠw•”‹~‹}ˆãŠwŒn‹~‹}W’†Ž¡—ÈãŠw•ª–ì
¹—ꉡ•l•a‰@ ‹~‹}‰È
¼ŒËŽs—§•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\ŒF–{ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}EW’†Ž¡—ÉÈ
϶‰ï‰F“s‹{•a‰@ ‹~‹}‰È
‘—§•a‰@‹@\ “Œ‹ß]‘‡ˆã—ÃZƒ“ƒ^[
‘—§•a‰@‹@\ …ŒËˆã—ÃZƒ“ƒ^[
“¡“c•ÛŒ’‰q¶‘åŠw‹~–½‹~‹}ˆãŠw

ŠO

–ß‚é

ˆã—Ö@l˜ßŽR‰ï “c‰ª•a‰@
ŽOd‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
MB‘åŠwˆãŠw•” ‹~‹}•”W’†Ž¡—ÈãŠw‹³Žº
¹ƒ}ƒŠƒA•a‰@ ‹~‹}‰È
ŒF–{‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}E‘‡f—Õ”
”ªŒËŽs—§Žs–¯•a‰@
•xŽR‘åŠw•‘®•a‰@ Šë‹@ŠÇ—ˆãŠw
ŽD–yˆã‰È‘åŠw ‹~‹}ˆãŠwuÀ
‘—§•a‰@‹@\‘åãˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ÂXŒ§—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‹T“c‘‡•a‰@ ‹~–½‹~‹}‰È
‡“V“°‘åŠwˆãŠw•”•‘®—û”n•a‰@ ‹~‹}EW’†Ž¡—ÉÈ
‘—§•a‰@‹@\–kŠC“¹ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
H“c‘åŠwˆãŠw•”•‘®•a‰@‹~‹}•”EW’†Ž¡—Õ”
ìŒûŽs—§ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘O‹´Ô\Žš•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[ W’†Ž¡—ÉÈE‹~‹}‰È
’†“ª•a‰@
å‘äŽs—§•a‰@ ‹~–½‹~‹}•”
•xŽmdH‹ÆŒ’N•ÛŒ¯‘g‡ ‘¾“c‹L”O•a‰@
²‰êŒ§ˆã—ÃZƒ“ƒ^[ D¶ŠÙ ‹~–½‹~‹}ƒZƒ“ƒ^[
•Ÿ‰ª‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
é‹Êˆã‰È‘åŠw‘‡ˆã—ÃZƒ“ƒ^[ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
Œú¶˜A‚‰ª•a‰@
’·è‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
•ŸˆäŒ§—§•a‰@
‘åãŽs—§‘åŠw‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
“ú–{Ô\ŽšŽÐˆã—ÃZƒ“ƒ^[
ŽÐ‰ïˆã—Ö@l‹ßX‰ï ‹ßX•a‰@
‰ÁŒÃ켎s–¯•a‰@
•½’ËŽs–¯•a‰@
‘—§•a‰@‹@\å‘äˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ˆ¤•Q‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}•”
‰ªŽR‘åŠw•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
•ŸŽRŽs–¯•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
é‹Êˆã‰È‘åŠw‘Ûˆã—ÃZƒ“ƒ^[
¼ŒËŽs—§•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
϶‰ï‰F“s‹{•a‰@ ‹~‹}‰È
‘—§•a‰@‹@\ “Œ‹ß]‘‡ˆã—ÃZƒ“ƒ^[
“¡“c•ÛŒ’‰q¶‘åŠw‹~–½‹~‹}ˆãŠw

ARDS

–ß‚é

ŽOd‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
JAL“‡‘‡•a‰@
¹ƒ}ƒŠƒA•a‰@ ‹~‹}‰È
ŒF–{‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}E‘‡f—Õ”
‡“V“°‘åŠwˆãŠw•”•‘®‰YˆÀ•a‰@ ‹~‹}f—ÉÈ
”ªŒËŽs—§Žs–¯•a‰@
‘—§•a‰@‹@\ЊQˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\“Ȗ؈ã—ÃZƒ“ƒ^[@
•xŽR‘åŠw•‘®•a‰@ Šë‹@ŠÇ—ˆãŠw
‘—§•a‰@‹@\‘åãˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ÂXŒ§—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‰FŽ¡“¿F‰ï•a‰@
‹T“c‘‡•a‰@ ‹~–½‹~‹}‰È
‡“V“°‘åŠwˆãŠw•”•‘®—û”n•a‰@ ‹~‹}EW’†Ž¡—ÉÈ
‘—§•a‰@‹@\–kŠC“¹ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
H“c‘åŠwˆãŠw•”•‘®•a‰@‹~‹}•”EW’†Ž¡—Õ”
ŽR—œ‘åŠwˆãŠw•”‹~‹}W’†Ž¡—ÈãŠwuÀ
L“‡Žs—§L“‡Žs–¯•a‰@ ‹~‹}‰È
‘O‹´Ô\Žš•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[ W’†Ž¡—ÉÈE‹~‹}‰È
’†“ª•a‰@
å‘äŽs—§•a‰@ ‹~–½‹~‹}•”
²‰êŒ§ˆã—ÃZƒ“ƒ^[ D¶ŠÙ ‹~–½‹~‹}ƒZƒ“ƒ^[
•Ÿ‰ª‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
Î쌧—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
’·è‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
‘åãŽs—§‘åŠw‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
“ú–{Ô\ŽšŽÐˆã—ÃZƒ“ƒ^[
”Ñ’Ë•a‰@
“Œ–¼Œú–Ø•a‰@
‘—§•a‰@‹@\“ì˜a‰ÌŽRˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
“Œ‹ž‘åŠwˆãŠw•”•‘®•a‰@
ˆ¤•Q‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}•”
‰ªŽR‘åŠw•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
“¿ŽR’†‰›•a‰@ ‹~‹}‰È
•ŸŽRŽs–¯•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
é‹Êˆã‰È‘åŠw‘Ûˆã—ÃZƒ“ƒ^[
Ž ‰êˆã‰È‘åŠw ‹~‹}EW’†Ž¡—Õ”
“ú–{‘åŠwˆãŠw•”‹~‹}ˆãŠwŒn‹~‹}W’†Ž¡—ÈãŠw•ª–ì
¹—ꉡ•l•a‰@ ‹~‹}‰È
¼ŒËŽs—§•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\ “Œ‹ß]‘‡ˆã—ÃZƒ“ƒ^[
‘—§•a‰@‹@\ …ŒËˆã—ÃZƒ“ƒ^[
“¡“c•ÛŒ’‰q¶‘åŠw‹~–½‹~‹}ˆãŠw

Œ€ÇŒ^Š´õÇ

–ß‚é

ŽOd‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
JAL“‡‘‡•a‰@
ŒF–{‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}E‘‡f—Õ”
”ªŒËŽs—§Žs–¯•a‰@
‘åãŽs—§‘‡ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\ЊQˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\“Ȗ؈ã—ÃZƒ“ƒ^[
•xŽR‘åŠw•‘®•a‰@ Šë‹@ŠÇ—ˆãŠw
ŽD–yˆã‰È‘åŠw ‹~‹}ˆãŠwuÀ
‰ªŽR϶‰ï‘‡•a‰@
‘—§•a‰@‹@\‘åãˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
ÂXŒ§—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‹T“c‘‡•a‰@ ‹~–½‹~‹}‰È
“Œ‹žˆã‰È‘åŠw”ª‰¤Žqˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
‡“V“°‘åŠwˆãŠw•”•‘®—û”n•a‰@ ‹~‹}EW’†Ž¡—ÉÈ
‘—§•a‰@‹@\–kŠC“¹ˆã—ÃZƒ“ƒ^[ ‹~–½‹~‹}ƒZƒ“ƒ^[
H“c‘åŠwˆãŠw•”•‘®•a‰@‹~‹}•”EW’†Ž¡—Õ”
ŽR—œ‘åŠwˆãŠw•”‹~‹}W’†Ž¡—ÈãŠwuÀ
L“‡Žs—§L“‡Žs–¯•a‰@ ‹~‹}‰È
‘O‹´Ô\Žš•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[ W’†Ž¡—ÉÈE‹~‹}‰È
’†“ª•a‰@
å‘äŽs—§•a‰@ ‹~–½‹~‹}•”
²‰êŒ§ˆã—ÃZƒ“ƒ^[ D¶ŠÙ ‹~–½‹~‹}ƒZƒ“ƒ^[
Î쌧—§’†‰›•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
’·è‘åŠw•a‰@‹~–½‹~‹}ƒZƒ“ƒ^[
‘åãŽs—§‘åŠwˆãŠw•”•‘®•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
“Œ‹žƒxƒCE‰YˆÀŽsìˆã—ÃZƒ“ƒ^[ ‹~‹}‰È
“ú–{Ô\ŽšŽÐˆã—ÃZƒ“ƒ^[
”Ñ’Ë•a‰@
ˆ¤•Q‘åŠwˆãŠw•”•‘®•a‰@ ‹~‹}•”
‰ªŽR‘åŠw•a‰@ ‚“x‹~–½‹~‹}ƒZƒ“ƒ^[
•ŸŽRŽs–¯•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
é‹Êˆã‰È‘åŠw‘Ûˆã—ÃZƒ“ƒ^[
Ž ‰êˆã‰È‘åŠw ‹~‹}EW’†Ž¡—Õ”
“ú–{‘åŠwˆãŠw•”‹~‹}ˆãŠwŒn‹~‹}W’†Ž¡—ÈãŠw•ª–ì
¹—ꉡ•l•a‰@ ‹~‹}‰È
¼ŒËŽs—§•a‰@ ‹~–½‹~‹}ƒZƒ“ƒ^[
‘—§•a‰@‹@\ “Œ‹ß]‘‡ˆã—ÃZƒ“ƒ^[
“¡“c•ÛŒ’‰q¶‘åŠw‹~–½‹~‹}ˆãŠw