Optimal ventilator settings in acute lung injury and acute respiratory distress syndrome.
Optimal ventilator settings in acute lung injury and acute respiratory distress syndrome.
复制标题
急性肺损伤和急性呼吸窘迫综合征的最佳呼吸机设置。
DOI：
10.1017/s0265021507003006
复制
发表时间：
2008
影响因子：
3.6
通讯作者：
Gajic,O
中科院分区：
文献类型：
--
作者：
Yilmaz,M;Gajic,O
尽管最近在重症监护医学、急性肺损伤及其更严重的形式方面取得了进展，但急性呼吸窘迫综合征构成了主要的治疗问题。虽然机械通气对这些患者的护理是不可或缺的，但其不良后果，包括呼吸机诱导的肺损伤，是疾病进展和预后的决定因素。在几个重要的呼吸机参数中，使用低潮气量可能是肺保护性机械通气最重要的特点。应对强化治疗人员进行培训，使其能够识别急性肺损伤和急性呼吸窘迫综合征，并鼓励他们在临床实践中使用低潮气量的呼吸机。对于传统的肺保护通气策略失败的患者，应保留替代的呼吸机模式，如高频呼吸机和俯卧位。
Despite recent advances in intensive care medicine, acute lung injury and its more severe form, acute respiratory distress syndrome pose major therapeutic problems. While mechanical ventilation is integral to the care of these patients, its adverse consequences including ventilator-induced lung injury are determinants of disease progression and prognosis. Among several important ventilator parameters, the use of low tidal volumes is probably the most important feature of lung-protective mechanical ventilation. Intensivists should be trained to recognize acute lung injury and acute respiratory distress syndrome and encouraged to use low-tidal-volume ventilation in clinical practice. Alternative modes of ventilation such as high-frequency ventilation and prone position should be reserved for selected patients in whom conventional lung-protective ventilation strategies have failed.