Is time the missing component in protective ventilation strategies?
Is time the missing component in protective ventilation strategies?
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时间是保护性通气策略中缺失的组成部分吗？
DOI：
10.1097/ccm.0b013e31828ce91b
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发表时间：
2013
影响因子：
8.8
通讯作者：
Habashi,Nader
中科院分区：
文献类型：
--
作者：
Nieman,Gary;Gatto,LouisA;Marx,William;Habashi,Nader
重症监护医生和重症监护医生敏锐地意识到，机械呼吸机，这是必不可少的，以保持他们的病人急性呼吸窘迫综合征（ARDS）活着，也可能是他们的死亡工具。40多年来，人们已经知道机械通气期间高气道压力对肺生理的负面影响（1）。1974年，Webb和Tierney首次证明机械通气可导致大鼠严重肺损伤（1）。此外，该开创性文章还表明，增加呼气末正压可减少肺水肿，并表明减少潮气量（Vt）可减少肺损伤。在随后的40年里，我们对呼吸机诱导的肺损伤（VILI）的病理生理学有了很多了解，但我们仍然不确定降低ARDS发病率和死亡率的最佳呼吸机策略（2）。
Critical care physicians and intensivists are acutely aware that the mechanical ventilator, which is essential to keep their patient with acute respiratory distress syndrome (ARDS) alive, may also be the instrument of their death. The negative impact on pulmonary physiology of high airway pressures during mechanical ventilation has been known for over 4 decades (1). In 1974, Webb and Tierney were the first to show that mechanical ventilation could cause severe lung injury in rats (1). In addition, that seminal article also showed that increasing positive end-expiratory pressure reduced pulmonary edema and suggested that reduced tidal volumes (Vt) may decrease lung injury. Much has been learned about the pathophysiology of ventilatorinduced lung injury (VILI) over the subsequent 40 years, but we are still uncertain of the optimal ventilator strategy to reduce ARDS morbidity and mortality (2).
影响因子：
158.5
作者：
Brower, RG;Matthay, MA;Sibbald, WJ
通讯作者：
Sibbald, WJ
影响因子：
38.9
作者：
Villar, Jesus;Blanco, Jesus;Kacmarek, Robert M.
通讯作者：
Kacmarek, Robert M.