Science review: mechanisms of ventilator-induced injury.
Science review: mechanisms of ventilator-induced injury.
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DOI：
10.1186/cc1829
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发表时间：
2003-06
期刊：
影响因子：
--
通讯作者：
Matthay MA
中科院分区：
文献类型：
--
作者：
Frank JA;Matthay MA
急性呼吸窘迫综合征（ARDS）和急性肺损伤是重症监护病房入院的最常见原因，约占入院人数的三分之一。在一些研究中，ARDS的死亡率估计高达70%。然而，直到最近，还没有发现靶向治疗可以改善患者的预后，包括死亡率。随着美国国立卫生研究院发起的急性呼吸窘迫综合征网络低潮气量研究的完成，临床医生现在有令人信服的证据表明，在该患者人群中使用比常规使用的潮气量低的潮气量通气可将死亡率的相对风险降低21%。这些数据证实了长期以来的怀疑，即机械通气对急性低氧性呼吸衰竭的作用不仅仅是支持性的，因为机械通气也可以积极促进肺损伤。低潮气量通气结合呼气末正压通气的保护作用机制尚未完全了解，是正在进行的研究的重点。本文旨在综述机械通气致急性肺损伤和ARDS患者肺损伤的细胞学机制。
Acute respiratory distress syndrome (ARDS) and acute lung injury are among the most frequent reasons for intensive care unit admission, accounting for approximately one-third of admissions. Mortality from ARDS has been estimated as high as 70% in some studies. Until recently, however, no targeted therapy had been found to improve patient outcome, including mortality. With the completion of the National Institutes of Health-sponsored Acute Respiratory Distress Syndrome Network low tidal volume study, clinicians now have convincing evidence that ventilation with tidal volumes lower than those conventionally used in this patient population reduces the relative risk of mortality by 21%. These data confirm the long-held suspicion that the role of mechanical ventilation for acute hypoxemic respiratory failure is more than supportive, in that mechanical ventilation can also actively contribute to lung injury. The mechanisms of the protective effects of low tidal volume ventilation in conjunction with positive end expiratory pressure are incompletely understood and are the focus of ongoing studies. The objective of the present article is to review the potential cellular mechanisms of lung injury attributable to mechanical ventilation in patients with ARDS and acute lung injury.
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影响因子：
3.3
作者：
COOPER, JA;VANDERZEE, H;MALIK, AB
通讯作者：
MALIK, AB
影响因子：
8.8
作者：
Brower, RG;Shanholtz, CB;Piantadosi, S
通讯作者：
Piantadosi, S
影响因子：
158.5
作者：
Amato, MBP;Barbas, CSV;Carvalho, CRR
通讯作者：
Carvalho, CRR
DOI：
10.1164/ajrccm.163.3.2003001
发表时间：
2001-03-01
影响因子：
24.7
作者：
Held, HD;Boettcher, S;Uhlig, S
通讯作者：
Uhlig, S
DOI：
10.1164/ajrccm.164.9.2103121
发表时间：
2001-11-01
影响因子：
24.7
作者：
Gattinoni, L;Caironi, P;Goodman, LR
通讯作者：
Goodman, LR