smpСкорая медицинская помощьEMERGENCY MEDICAL CARE2072-6716Northwest State Medical University named after II Mechnikov10.24884/2072-6716-2015-16-1-31-41smp-66Research ArticleОБЗОРЫREVIEWSСОВРЕМЕННЫЕ ПРЕДСТАВЛЕНИЯ О ПАТОГЕНЕТИЧЕСКИХ МЕХАНИЗМАХ ОСТРОГО РЕСПИРАТОРНОГО ДИСТРЕСС- СИНДРОМА (ЧАСТЬ 2)1MODERN CONCEPTIONS OF PATHOGENETIC MECHANISMS OF ACUTE RESPIRATORY DYSTRESS SYNDROME (PART 2)ПовзунС. А.PovzunS. A.noemail@neicon.ruСанкт-Петербургский научно-исследовательский институт скорой помощи им. И. И. Джанелидзе,РоссияDzhanelidze Research Institute of Emergency Care,Russian Federation2015231220161613141Copyright © Повзун С.А., 20162016Повзун С.А.Povzun S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://smp.spb.ru/jour/article/view/66

На основе анализа литературы изложены представления о биологической сущности острого респираторного дистресс-синдрома и механизмах его развития при различных патологических состояниях.

On the basis of the analysis of literature modern conceptions of mechanisms of the development of acute respiratory distress-syndrome as a complication of different pathological conditions are discussed.

острый респираторный дистресс-синдромпатогенетические механизмыacute respiratory distress-syndromepathogenesisReferencesBeck-Schimmer B., Rosenberger D. S., Neff S. B. et al. Pulmonary aspiration: new therapeutic approaches in the experimental model // Anesthesiology.- 2005.- Vol. 103, N 3.- P. 556-566.Beck-Schimmer B., Rosenberger D. S., Neff S. B. et al. Pulmonary aspiration: new therapeutic approaches in the experimental model // Anesthesiology.- 2005.- Vol. 103, N 3.- P. 556-566.Matthay M. A., Folkesson H. G., Clerici C. Lung epithelial fluid transport and the resolution of pulmonary edema // Physiol. Rev.- 2002.- Vol. 82, N 3.- P. 569-600.Matthay M. A., Folkesson H. G., Clerici C. Lung epithelial fluid transport and the resolution of pulmonary edema // Physiol. Rev.- 2002.- Vol. 82, N 3.- P. 569-600.Ware L. B., Matthay M. A. The acute respiratory distress // N. Engl. J. Med.- 2000.- Vol. 342, N 9.- P. 1334-1349.Ware L. B., Matthay M. A. The acute respiratory distress // N. Engl. J. Med.- 2000.- Vol. 342, N 9.- P. 1334-1349.Повзун С. А. Важнейшие синдромы: патогенез и патологическая анатомия.- СПб.: ООО «ИПК «КОСТА», 2009.- 480 с.Повзун С. А. Важнейшие синдромы: патогенез и патологическая анатомия.- СПб.: ООО «ИПК «КОСТА», 2009.- 480 с.Susiva C., Boonrong T. Near-drowning in pediatric respiratory intensive care unit, Siriraj hospital // J. Med. Assoc. Thai.- 2005.- Vol. 88, suppl. 8.- S. 44-47.Susiva C., Boonrong T. Near-drowning in pediatric respiratory intensive care unit, Siriraj hospital // J. Med. Assoc. Thai.- 2005.- Vol. 88, suppl. 8.- S. 44-47.Чучалин А. Г. Синдром острого повреждения легких // Тер. архив.- 2007.- Т. 79, № 3.- С. 5-10.Чучалин А. Г. Синдром острого повреждения легких // Тер. архив.- 2007.- Т. 79, № 3.- С. 5-10.Rinaldo J. E., Rogers R. M. Adult respiratory-distress syndrome: changing concepts of lung injury and repair // N. Engl. J. Med.- 1982.- Vol. 306, N 15.- P. 900-909.Rinaldo J. E., Rogers R. M. Adult respiratory-distress syndrome: changing concepts of lung injury and repair // N. Engl. J. Med.- 1982.- Vol. 306, N 15.- P. 900-909.Altemeier W. A., Sinclair S. E. Hyperoxia in the intensive care unit: why more is not always better // Curr. Opin. Crit. Care.- 2007.- Vol. 13, N 1.- P. 73-78.Altemeier W. A., Sinclair S. E. Hyperoxia in the intensive care unit: why more is not always better // Curr. Opin. Crit. Care.- 2007.- Vol. 13, N 1.- P. 73-78.Brower R. G., Lanken P. N., MacIntyre N. et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome // N. Engl. J. Med.- 2004.- Vol. 351, N 4.- P. 327-336.Brower R. G., Lanken P. N., MacIntyre N. et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome // N. Engl. J. Med.- 2004.- Vol. 351, N 4.- P. 327-336.Jain M., Sznajder J. I. Bench-to-bedside review: distal airways in acute respiratory distress syndrome // Crit. Care.- 2007.- Vol. 11, N 1.- P. 206.Jain M., Sznajder J. I. Bench-to-bedside review: distal airways in acute respiratory distress syndrome // Crit. Care.- 2007.- Vol. 11, N 1.- P. 206.Hachenberg T., Rettig R. Stress failure of the blood-gas barrier // Curr. Opin. Anaestesiol.- 1998.- Vol. 11, N 1.- P. 37-44.Hachenberg T., Rettig R. Stress failure of the blood-gas barrier // Curr. Opin. Anaestesiol.- 1998.- Vol. 11, N 1.- P. 37-44.Han B. Ventilator-induced lung injury: role of protein-protein interaction in mechanosensation // Proc. Am. Thorac. Soc.- 2005.- Vol. 2, N 3.- P. 181-187.Han B. Ventilator-induced lung injury: role of protein-protein interaction in mechanosensation // Proc. Am. Thorac. Soc.- 2005.- Vol. 2, N 3.- P. 181-187.Verbrugge S. J., Sorm V., Lachmann B. Мechanisms of acute respiratory distress syndrome: role of surfactant changes and mechanical ventilation // J. Physiol. Pharmacol.- 1997.- Vol. 48, N 4.- Р. 537-557.Verbrugge S. J., Sorm V., Lachmann B. Мechanisms of acute respiratory distress syndrome: role of surfactant changes and mechanical ventilation // J. Physiol. Pharmacol.- 1997.- Vol. 48, N 4.- Р. 537-557.Gattinoni L., Chiumello D., Cressoni M. et al. Pulmonary computed tomography and adult respiratory distress syndrome // Swiss Med. Weekly.- 2005.- Vol. 135.- P. 169-174.Gattinoni L., Chiumello D., Cressoni M. et al. Pulmonary computed tomography and adult respiratory distress syndrome // Swiss Med. Weekly.- 2005.- Vol. 135.- P. 169-174.Theodore J., Robin E. D. Speculations on neurogenic pulmonary edema (NPE) // Am. Rev. Resp. Dis.- 1976.- Vol. 113, N 4.- P. 405-411.Theodore J., Robin E. D. Speculations on neurogenic pulmonary edema (NPE) // Am. Rev. Resp. Dis.- 1976.- Vol. 113, N 4.- P. 405-411.Kahn J. M., Caldwell E. C., Deem S. et al. Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome // Crit. Care Med.- 2006.- Vol. 34, N 1.- P. 196-202.Kahn J. M., Caldwell E. C., Deem S. et al. Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome // Crit. Care Med.- 2006.- Vol. 34, N 1.- P. 196-202.Klein Y., Cohn S. M., Proctor K. G. Lung contusion: pathophysiology and management // Curr. Opin. Anaestesiol.- 2002.- Vol. 15, N 1.- P. 65-68.Klein Y., Cohn S. M., Proctor K. G. Lung contusion: pathophysiology and management // Curr. Opin. Anaestesiol.- 2002.- Vol. 15, N 1.- P. 65-68.Hardaway R. M. A brief overview of acute respiratory distress syndrome // World J. Surg.- 2006.- Vol. 30, N 10.- P. 1829-1834.Hardaway R. M. A brief overview of acute respiratory distress syndrome // World J. Surg.- 2006.- Vol. 30, N 10.- P. 1829-1834.Radhakrishnan J., Markowitz G., Cohen D. J. Respiratory distress in a patient with rhabdomyolysis-induced acute renal failure // Kidney Int.- 2006.- Vol. 69, N 1.- P. 7.Radhakrishnan J., Markowitz G., Cohen D. J. Respiratory distress in a patient with rhabdomyolysis-induced acute renal failure // Kidney Int.- 2006.- Vol. 69, N 1.- P. 7.Koksal C., Bozkurt A. K., Ustundag N. et al. Attenuation of acute lung injury following lower limb ischemia/ reperfusion: the pharmacological approach // Cardiovasc. Surg. (Torino).- 2006.- Vol. 47, N 4.- P. 445-449.Koksal C., Bozkurt A. K., Ustundag N. et al. Attenuation of acute lung injury following lower limb ischemia/ reperfusion: the pharmacological approach // Cardiovasc. Surg. (Torino).- 2006.- Vol. 47, N 4.- P. 445-449.Fowler A. A., Hamman R. F., Good J. T. et al. Adult respiratory distress syndrome: risk with common predisposition // Ann. Intern. Med.- 1983.- Vol. 98, N 5, Pt. 1.- P. 593-597.Fowler A. A., Hamman R. F., Good J. T. et al. Adult respiratory distress syndrome: risk with common predisposition // Ann. Intern. Med.- 1983.- Vol. 98, N 5, Pt. 1.- P. 593-597.Niederman M. S., Fein A. M. Sepsis syndrome, the adult respiratory distress syndrome, and nosocomial pneumonia: a common clinical sequence // Clin. Chest Med.- 1990.- Vol. 11, N. 4.- P. 633-656.Niederman M. S., Fein A. M. Sepsis syndrome, the adult respiratory distress syndrome, and nosocomial pneumonia: a common clinical sequence // Clin. Chest Med.- 1990.- Vol. 11, N. 4.- P. 633-656.Piantadosi С. A., Schwartz D. A. The acute respiratory distress syndrome // Ann. Intern. Med.- 2004.- Vol. 141, N 6.- P. 460-470.Piantadosi С. A., Schwartz D. A. The acute respiratory distress syndrome // Ann. Intern. Med.- 2004.- Vol. 141, N 6.- P. 460-470.Miyake Y., Kaise H., Isono К. et al. Protective role of macrophages in noninflammatory lung injury caused by selective ablation of alveolar epithelial type II cells // J. Immunol.- 2007.- Vol. 178, N 8.- P. 5001-5009.Miyake Y., Kaise H., Isono К. et al. Protective role of macrophages in noninflammatory lung injury caused by selective ablation of alveolar epithelial type II cells // J. Immunol.- 2007.- Vol. 178, N 8.- P. 5001-5009.Winn R. K., Mihelicic D., Vedder N. B. et al. Monoclonal antibodies to leukocyte and endothelial adhesion molecules attenuate ischemia-reperfusion injury // Behring Inst. Mitt.- 1993.- N 92.- P. 229-237.Winn R. K., Mihelicic D., Vedder N. B. et al. Monoclonal antibodies to leukocyte and endothelial adhesion molecules attenuate ischemia-reperfusion injury // Behring Inst. Mitt.- 1993.- N 92.- P. 229-237.Bаum M., Benzer H., Haider W. et al. Zur Geneze der Atemstorungen bei der Fettembolie // Wien. Klin. Wschr.- 1970.- Bd. 82.- S. 855-858.Bаum M., Benzer H., Haider W. et al. Zur Geneze der Atemstorungen bei der Fettembolie // Wien. Klin. Wschr.- 1970.- Bd. 82.- S. 855-858.Воинов В. А., Овчинин А. Ф., Данилов Е. Н. и др. Изменения сурфактантной системы легких при операциях с искусственным кровообращением // Проблемы пульмонологии.- 1978.- Вып. 7.- С. 262-264.Воинов В. А., Овчинин А. Ф., Данилов Е. Н. и др. Изменения сурфактантной системы легких при операциях с искусственным кровообращением // Проблемы пульмонологии.- 1978.- Вып. 7.- С. 262-264.Ставская В. В. Нарушения аппарата дыхания при почечной недостаточности // Хроническая почечная недостаточность.- Л.: Медицина, 1976.- С. 148-183.Ставская В. В. Нарушения аппарата дыхания при почечной недостаточности // Хроническая почечная недостаточность.- Л.: Медицина, 1976.- С. 148-183.Bux J., Sachs U. J. The pathogenesis of transfusion-related acute lung injuri (TRALI) // Br. J. Haematol.- 2007.- Vol. 136, N 6.- P. 788-799.Bux J., Sachs U. J. The pathogenesis of transfusion-related acute lung injuri (TRALI) // Br. J. Haematol.- 2007.- Vol. 136, N 6.- P. 788-799.Triulzi D. J. Transfusion-related acute lung injury: an update // Hematology Am. Soc. Hematol. Educ. Program.- 2006.- P. 497-501.Triulzi D. J. Transfusion-related acute lung injury: an update // Hematology Am. Soc. Hematol. Educ. Program.- 2006.- P. 497-501.Silverboard H., Aisiku I., Martin G. S. et al. The role of acute blood transfusion in the development of acute respiratory distress syndrome in patients with severe trauma // J. Trauma.- 2005.- Vol. 59, N 3.- P. 717-723.Silverboard H., Aisiku I., Martin G. S. et al. The role of acute blood transfusion in the development of acute respiratory distress syndrome in patients with severe trauma // J. Trauma.- 2005.- Vol. 59, N 3.- P. 717-723.Bhatia M., Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome // J. Pathol.- 2004.- Vol. 202, N 2.- P. 145-156.Bhatia M., Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome // J. Pathol.- 2004.- Vol. 202, N 2.- P. 145-156.Bhatia M. Inflammatory response on pancreatic acinar cell injury / M. Bhatia // Scand. J. Surg.- 2005.- Vol. 94, N 2.- P. 97-102.Bhatia M. Inflammatory response on pancreatic acinar cell injury / M. Bhatia // Scand. J. Surg.- 2005.- Vol. 94, N 2.- P. 97-102.Steer M. L. The early intraacinar cell events which occur during acute pancreatitis // Pancreas.- 1998.- Vol. 17, N 1.- P. 31-37.Steer M. L. The early intraacinar cell events which occur during acute pancreatitis // Pancreas.- 1998.- Vol. 17, N 1.- P. 31-37.Zhao X., Andersson R., Wang X. et al. Acute pancreatitis-associated lung injury: pathophysiological mechanisms and potential future therapies // Scand. J. Gastroenterol.- 2002.- Vol. 37, N 12.- P. 1351-1358.Zhao X., Andersson R., Wang X. et al. Acute pancreatitis-associated lung injury: pathophysiological mechanisms and potential future therapies // Scand. J. Gastroenterol.- 2002.- Vol. 37, N 12.- P. 1351-1358.Buter A., Imrie C. W., Carter C. R. et al. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis // Br. J. Surg.- 2002.- Vol. 89, N 3.- P. 298-302.Buter A., Imrie C. W., Carter C. R. et al. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis // Br. J. Surg.- 2002.- Vol. 89, N 3.- P. 298-302.Steinberg W. M., Tenner S. Acute pancreatitis // N. Engl. J. Med.- 1994.- Vol. 330, N 17.- P. 1198-1210.Steinberg W. M., Tenner S. Acute pancreatitis // N. Engl. J. Med.- 1994.- Vol. 330, N 17.- P. 1198-1210.Browne G. W., Pitchumoni C. S. Pathophysiology of pulmonary complications of acute pancreatitis // World J. Gastroenterol.- 2006.- Vol. 12, N 44.- P. 7087-7096.Browne G. W., Pitchumoni C. S. Pathophysiology of pulmonary complications of acute pancreatitis // World J. Gastroenterol.- 2006.- Vol. 12, N 44.- P. 7087-7096.Imrie C. W., Ferguson J. C., Murphy D. et al. Arterial hypoxia in acute pancreatitis // Br. J. Surg.- 1977.- Vol. 64, N 3.- P. 185-188.Imrie C. W., Ferguson J. C., Murphy D. et al. Arterial hypoxia in acute pancreatitis // Br. J. Surg.- 1977.- Vol. 64, N 3.- P. 185-188.Murphy D., Pack A. I., Imrie C. W. The mechanism of arterial hypoxia occurring in acute pancreatitis // Q. J. Med.- 1980.- Vol. 49, N 194.- P. 151-163.Murphy D., Pack A. I., Imrie C. W. The mechanism of arterial hypoxia occurring in acute pancreatitis // Q. J. Med.- 1980.- Vol. 49, N 194.- P. 151-163.Interiano B., Stuard I. D., Hyde R. W. Acute respiratory distress syndrome in pancreatitis // Ann. Intern. Med.- 1972.- Vol. 77, N 6.- P. 923-926.Interiano B., Stuard I. D., Hyde R. W. Acute respiratory distress syndrome in pancreatitis // Ann. Intern. Med.- 1972.- Vol. 77, N 6.- P. 923-926.Guice K. S., Oldham K. T., Wolfe R. R. et al. Lung injury in acute pancreatitis: primary inhibition of pulmonary phospholipid synthesis // Am. J. Surg.- 1987.- Vol. 153, N 1.- P. 54-61.Guice K. S., Oldham K. T., Wolfe R. R. et al. Lung injury in acute pancreatitis: primary inhibition of pulmonary phospholipid synthesis // Am. J. Surg.- 1987.- Vol. 153, N 1.- P. 54-61.Matuszczak Y., Viires N., Aubier M. et al. Diaphragmatic function is markedly altered in cerulean-induced pancreatitis // Crit. Care. Med- 1998.- Vol. 26, N 8.- P. 1327-1331.Matuszczak Y., Viires N., Aubier M. et al. Diaphragmatic function is markedly altered in cerulean-induced pancreatitis // Crit. Care. Med- 1998.- Vol. 26, N 8.- P. 1327-1331.McFadden D. W. Organ failure and multiple organ system failure in pancreatitis // Pancreas.- 1991.- Vol. 6, suppl. 1.- S. 37-43.McFadden D. W. Organ failure and multiple organ system failure in pancreatitis // Pancreas.- 1991.- Vol. 6, suppl. 1.- S. 37-43.McNaughton P. D., Evans T. W. Management of adult respiratory distress syndrome // Lancet.- 1992.- Vol. 339, N 8791.- P. 469-472.McNaughton P. D., Evans T. W. Management of adult respiratory distress syndrome // Lancet.- 1992.- Vol. 339, N 8791.- P. 469-472.Berry A. R., Taylor T. V., Davies G. C. Pulmonary function and fibrinogen metabolism in acute pancreatitis // Br. J. Surg.- 1981.- Vol. 68, N 12.- P. 870-873.Berry A. R., Taylor T. V., Davies G. C. Pulmonary function and fibrinogen metabolism in acute pancreatitis // Br. J. Surg.- 1981.- Vol. 68, N 12.- P. 870-873.Rosen H. R., Tuchler H. Pulmonary injury in acute experimental pancreatitis correlates with elevated levels of free fatty acids in rats // HPB Surg.- 1992.- Vol. 6, N 2.- P. 79-90.Rosen H. R., Tuchler H. Pulmonary injury in acute experimental pancreatitis correlates with elevated levels of free fatty acids in rats // HPB Surg.- 1992.- Vol. 6, N 2.- P. 79-90.Büchler M., Malfertheiner P., Schadlich H. et al. Role of phospholipase A2 in human acute pancreatitis // Gastroenterology.- 1989.- Vol. 97, N 6.- P. 1521-1526.Büchler M., Malfertheiner P., Schadlich H. et al. Role of phospholipase A2 in human acute pancreatitis // Gastroenterology.- 1989.- Vol. 97, N 6.- P. 1521-1526.Nevalainen T. J., Gronroos J. M., Kortesuo P. T. Pancreatic and synovial type phospholipases A2 in serum samples from patients with severe acute pancreatitis // Gut.- 1993.- Vol. 34, N 8.- P. 1133-1136.Nevalainen T. J., Gronroos J. M., Kortesuo P. T. Pancreatic and synovial type phospholipases A2 in serum samples from patients with severe acute pancreatitis // Gut.- 1993.- Vol. 34, N 8.- P. 1133-1136.Kingsnorth A. Role of cytokines and their inhibitors in acute pancreatitis // Gut.- 1997.- Vol. 40, N 1.- P. 1-4.Kingsnorth A. Role of cytokines and their inhibitors in acute pancreatitis // Gut.- 1997.- Vol. 40, N 1.- P. 1-4.Kimura T., Toung J. K., Margolis S. et al. Respiratory failure in acute pancreatitis: the role of free fatty acids // Surgery.- 1980.- Vol. 87, N 5.- P. 509-513.Kimura T., Toung J. K., Margolis S. et al. Respiratory failure in acute pancreatitis: the role of free fatty acids // Surgery.- 1980.- Vol. 87, N 5.- P. 509-513.Gukovskaya A. S., Vaquero E., Zaninovitz V. et al. Neutrophils and NADPH oxidase mediate intrapancreatic trypsin activation in murine experimental acute pancreatitis // Gastroenterology.- 2002.- Vol. 122, N 4.- P. 974-984.Gukovskaya A. S., Vaquero E., Zaninovitz V. et al. Neutrophils and NADPH oxidase mediate intrapancreatic trypsin activation in murine experimental acute pancreatitis // Gastroenterology.- 2002.- Vol. 122, N 4.- P. 974-984.Denham W., Yang J., Wang H. et al. Inhibition of p38 mitogen activate kinase attenuates the severity of pancreatitis- induced adult respiratory distress syndrome // Crit. Care Med.- 2000.- Vol. 28, N 7.- P. 2567-2572.Denham W., Yang J., Wang H. et al. Inhibition of p38 mitogen activate kinase attenuates the severity of pancreatitis- induced adult respiratory distress syndrome // Crit. Care Med.- 2000.- Vol. 28, N 7.- P. 2567-2572.Hughes C. B., Grewal H. P., Gaber L. W. Anti-TNFalpha therapy improves survival and ameliorates the pathophysiologic sequelae in acute pancreatitis in the rat // Am. J. Surg.- 1996.- Vol. 171, N 2.- P. 274-280.Hughes C. B., Grewal H. P., Gaber L. W. Anti-TNFalpha therapy improves survival and ameliorates the pathophysiologic sequelae in acute pancreatitis in the rat // Am. J. Surg.- 1996.- Vol. 171, N 2.- P. 274-280.Miller E. J. Elevated levels of NAP-1/interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality / E. J. Miller, A. B. Cohen, S. Nagao et al. // Am. Rev. Respir. Dis.- 1992.- Vol. 146, N 2.- P. 427-432.Miller E. J. Elevated levels of NAP-1/interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality / E. J. Miller, A. B. Cohen, S. Nagao et al. // Am. Rev. Respir. Dis.- 1992.- Vol. 146, N 2.- P. 427-432.Lo C. J., Fu M., Cryer H. G. Interleukin 10 inhibits alveolar macrophage production of inflammatory mediators involved in adult respiratory distress syndrome // J. Surg. Res.- 1998.- Vol. 79, N 2.- P. 179-184.Lo C. J., Fu M., Cryer H. G. Interleukin 10 inhibits alveolar macrophage production of inflammatory mediators involved in adult respiratory distress syndrome // J. Surg. Res.- 1998.- Vol. 79, N 2.- P. 179-184.Bucciarelli S., Espinosa G., Asherson R. A. et al. The acute respiratory distress syndrome in catastrophic antiphospholipid syndrome: analysis of a series of 47 patients // Ann. Rheum. Dis.- 2006.- Vol. 65, N 1.- P. 81-86.Bucciarelli S., Espinosa G., Asherson R. A. et al. The acute respiratory distress syndrome in catastrophic antiphospholipid syndrome: analysis of a series of 47 patients // Ann. Rheum. Dis.- 2006.- Vol. 65, N 1.- P. 81-86.Ивашкин В. Т., Алексеев В. Г., Мошиашвили В. И. и др. Респираторный дистресс-синдром взрослых у больных с инфекциями // Клин. мед.- 1992.- Т. 70, № 3-4.- С. 24-27.Ивашкин В. Т., Алексеев В. Г., Мошиашвили В. И. и др. Респираторный дистресс-синдром взрослых у больных с инфекциями // Клин. мед.- 1992.- Т. 70, № 3-4.- С. 24-27.

The authors declare that there are no conflicts of interest present.