中国当代儿科杂志2013，Vol.15Issue(6)：496-500,封3,6.DOI:10.7499/j.issn.1008-8830.2013.06.023
急性呼吸窘迫综合征机械通气策略的新进展
Mechanical ventilation in acute respiratory distress syndrome
王亚妹1
作者信息
- 1. 四川大学华西第二医院儿科,四川成都610041
- 折叠
摘要
Abstract
The goal of mechanically ventilating patients with acute respiratory distress syndrome (ARDS) is to ensure adequate oxygenation and minimal ventilator-associated lung injury.Non-invasive ventilation should be cautiously used in patients with ARDS.Protective ARDS mechanical ventilation strategies with low tidal volumes can reduce mortality.Driving pressure is the most reasonable parameter to optimize tidal volume.Available evidence does not support the routine use of higher positive end expiratory pressure (PEEP) in patients with ARDS.The optimal level of PEEP may be titrated by the inflection point obtained from static pressure-volume curve.Promising therapies include prone position ventilation,high frequency oscillatory ventilation and extracorporeal membrane oxygenation as salvage treatment.While mechanically ventilating,it is also important for ARDS patients to maintain spontaneous breathing via assisted ventilation mode such as bilevel positive airway pressure,pressure support ventilation and neurally adjusted ventilation assist.Exogenous surfactant,inhaled nitric oxide,bronchodilators,airway pressure release ventilation and partial liquid ventilation are not recommended therapies.关键词
急性呼吸窘迫综合征/机械通气Key words
Acute respiratory distress syndrome/ Mechanical ventilation引用本文复制引用
王亚妹..急性呼吸窘迫综合征机械通气策略的新进展[J].中国当代儿科杂志,2013,15(6):496-500,封3,6.
