口服 β 受体阻滞剂
虽然还需要进一步的研究来证实早期发现,但是 ICU 患者口服 β-受体阻滞剂治疗急性呼吸衰竭可能降低住院死亡率和 1 年死亡率。[75]Noveanu M, Breidthardt T, Reichlin T, et al. Effect of oral beta-blocker on short and long-term mortality in patients with acute respiratory failure: results from the BASEL-II-ICU study. Crit Care. 2010;14:R198.http://ccforum.com/content/14/6/R198http://www.ncbi.nlm.nih.gov/pubmed/21047406?tool=bestpractice.com
体外膜肺氧合 (extracorporeal membrane oxygenation, ECMO)
ECMO 用于成人和儿童重度急性呼吸衰竭是潜在的技术进步。目前 ECMO 较为复杂且价格昂贵,仅在经验丰富的、大的和专业的中心开展。[76]Combes A, Brodie D, Bartlett R, et al.; The International ECMO Network (ECMONet). Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med. 2014;190:488-496.http://www.atsjournals.org/doi/full/10.1164/rccm.201404-0630CP#.VyvRDnoYG9Yhttp://www.ncbi.nlm.nih.gov/pubmed/25062496?tool=bestpractice.com[77]Munshi L, Telesnicki T, Walkey A, et al. Extracorporeal life support for acute respiratory failure. A systematic review and metaanalysis. Ann Am Thorac Soc. 2014;11:802-810.http://www.ncbi.nlm.nih.gov/pubmed/24724902?tool=bestpractice.com[78]Tramm R, Ilic D, Davies AR, et al. Extracorporeal membrane oxygenation for critically ill adults. Cochrane Database Syst Rev. 2015;(1):CD010381.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010381.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/25608845?tool=bestpractice.com
用于神经系统功能障碍的膈肌起搏
膈肌起搏类似于心脏起搏,可能对膈肌功能有神经受损的患者具有可能获益。然而,单项研究显示,无创通气的标准治疗中增加膈肌起搏可导致肌萎缩侧索硬化 (ALS) 患者的存活期缩短。[79]McDermott CJ, Bradburn MJ, Maguire C, et al; DiPALS Writing Committee; DiPALS Study Group Collaborators. Safety and efficacy of diaphragm pacing in patients with respiratory insufficiency due to amyotrophic lateral sclerosis (DiPALS): a multicentre, open-label, randomised controlled trial. Lancet Neurol. 2015;14:883-892.http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2815%2900152-0/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/26234554?tool=bestpractice.com