Novel approaches to minimize ventilator-induced lung injury.
Novel approaches to minimize ventilator-induced lung injury.
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DOI：
10.1186/1741-7015-11-85
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发表时间：
2013-03-28
期刊：
影响因子：
9.3
通讯作者：
Slutsky AS
中科院分区：
文献类型：
--
作者：
Fan E;Villar J;Slutsky AS
尽管有40多年的研究，但对于急性呼吸窘迫综合征（ARDS）没有特异性的肺定向治疗。尽管我们对其发病机制和影响患者预后的因素的理解有了很大的发展，但机械通气的支持性护理仍然是治疗的基石。也许在ARDS研究中最重要的进展是认识到机械通气虽然对维持生命是必要的，但其本身可以通过统称为呼吸机诱导的肺损伤（VILI）的各种机制加重或引起肺损伤。这种对ARDS和VILI理解的提高对于设计旨在减轻VILI和改善预后的肺保护性治疗策略非常重要。为了提高我们对VILI机制的理解，并开发新的预防策略和治疗干预措施来预防和改善VILI，以改善ARDS患者的结局，已经做出了相当大的努力。在这篇综述中，我们将回顾VILI的病理生理学，讨论一些新的生理方法，以尽量减少VILI，治疗，以抵消生物创伤，并强调了一些实验研究，以支持这些概念。
Despite over 40 years of research, there is no specific lung-directed therapy for the acute respiratory distress syndrome (ARDS). Although much has evolved in our understanding of its pathogenesis and factors affecting patient outcome, supportive care with mechanical ventilation remains the cornerstone of treatment. Perhaps the most important advance in ARDS research has been the recognition that mechanical ventilation, although necessary to preserve life, can itself aggravate or cause lung damage through a variety of mechanisms collectively referred to as ventilator-induced lung injury (VILI). This improved understanding of ARDS and VILI has been important in designing lung-protective ventilatory strategies aimed at attenuating VILI and improving outcomes. Considerable effort has been made to enhance our mechanistic understanding of VILI and to develop new ventilatory strategies and therapeutic interventions to prevent and ameliorate VILI with the goal of improving outcomes in patients with ARDS. In this review, we will review the pathophysiology of VILI, discuss a number of novel physiological approaches for minimizing VILI, therapies to counteract biotrauma, and highlight a number of experimental studies to support these concepts.
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10.1164/rccm.200710-1589oc
发表时间：
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影响因子：
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