急性呼吸窘迫综合征
医学
通风(建筑)
机械通风
潮气量
麻醉
平均气道压
体外膜肺氧合
呼气末正压
充氧
压力支持通气
最大吸气压力
气道
肺
呼吸系统
内科学
工程类
机械工程
出处
期刊:CRC Press eBooks
[Informa]
日期:2016-04-19
卷期号:: 353-376
被引量:2
标识
DOI:10.3109/9781420088410-21
摘要
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.
科研通智能强力驱动
Strongly Powered by AbleSci AI