优化通风功率,避免VILI。

IF 3.8 2区 医学 Q1 CRITICAL CARE MEDICINE
Lauren T Thornton, John J Marini
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引用次数: 0

摘要

将VILI风险最小化的努力必须是多管齐下的。适当的通气需求是危险力量的关键决定因素,通过明智的允许性高碳酸血症,减少先天需氧量,以及俯卧体位促进有效的肺部气体交换和局部压力的均匀分布,可以减少通气需求。可改变的与呼吸机相关的肺保护决定因素包括潮气量、平台压力、驱动压力、PEEP、吸气流量振幅和轮廓(使用更长的吸气呼气比)和通气频率的降低。被低估的调节局部比功率影响的重要条件辅助因素可能包括较低的血管压和血流量。这些措施一起使用,调节通气功率,目的是避免VILI,同时达到临床可接受的肺气体交换目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimized ventilation power to avoid VILI.

The effort to minimize VILI risk must be multi-pronged. The need to adequately ventilate, a key determinant of hazardous power, is reduced by judicious permissive hypercapnia, reduction of innate oxygen demand, and by prone body positioning that promotes both efficient pulmonary gas exchange and homogenous distributions of local stress. Modifiable ventilator-related determinants of lung protection include reductions of tidal volume, plateau pressure, driving pressure, PEEP, inspiratory flow amplitude and profile (using longer inspiration to expiration ratios), and ventilation frequency. Underappreciated conditional cofactors of importance to modulate the impact of local specific power may include lower vascular pressures and blood flows. Employed together, these measures modulate ventilation power with the intent to avoid VILI while achieving clinically acceptable targets for pulmonary gas exchange.

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来源期刊
Journal of Intensive Care
Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
11.90
自引率
1.40%
发文量
51
审稿时长
15 weeks
期刊介绍: "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.
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