Ventilator-Associated Lung Injury

作者: Robert M. Kacmarek

DOI: 10.1097/00004311-199903730-00007

关键词: Animal speciesHigh peakPulmonary gas pressuresARDSAirwayVentilator-associated lung injuryMedicineBeneficial effectsRandomized controlled trialIntensive care medicineAnesthesiology and Pain Medicine

摘要: There is injury caused in numerous animal species when overdistending airway pressure and volume are delivered. The extent of this attenuated by the application PEEP. Patient case series point to benefit LPVS. In randomized controlled trials, data may appear confusing. However, based on from Amato colleagues' trial, it seems prudent employ an LPVS individual patient's lung mechanics. Based trials discussed appears that many have been convinced detrimental effects high peak alveolar pressure. It remains convince clinicians beneficial use higher PEEP early ARDS respiratory system mechanics patient recruitment maneuvers. conclusion, I concur with Dreyfuss Saumon Slutsky Tremblay not only attenuate severity preventing VALI, but also prevent MODS or its severity.

参考文章(7)
JAMES C. PARKER, LUCRECIA A. HERNANDEZ, KEITH J. PEEVY, Mechanisms of ventilator-induced lung injury Critical Care Medicine. ,vol. 21, pp. 131- 143 ,(1993) , 10.1097/00003246-199301000-00024
J. J. Rouby, T. Lherm, E. Martin de Lassale, P. Poète, L. Bodin, J. F. Finet, P. Callard, P. Viars, Histologic aspects of pulmonary barotrauma in critically ill patients with acute respiratory failure Intensive Care Medicine. ,vol. 19, pp. 383- 389 ,(1993) , 10.1007/BF01724877
L Tremblay, F Valenza, S P Ribeiro, J Li, A S Slutsky, Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. Journal of Clinical Investigation. ,vol. 99, pp. 944- 952 ,(1997) , 10.1172/JCI119259
Z. Fu, M. L. Costello, K. Tsukimoto, R. Prediletto, A. R. Elliott, O. Mathieu-Costello, J. B. West, High lung volume increases stress failure in pulmonary capillaries. Journal of Applied Physiology. ,vol. 73, pp. 123- 133 ,(1992) , 10.1152/JAPPL.1992.73.1.123
V. Marco Ranieri, Peter M. Suter, Cosimo Tortorella, Renato De Tullio, Jean Michel Dayer, Antonio Brienza, Francesco Bruno, Arthur S. Slutsky, Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA. ,vol. 282, pp. 54- 61 ,(1999) , 10.1001/JAMA.282.1.54
DIDIER DREYFUSS, GEORGES SAUMON, Ventilator-induced lung injury: lessons from experimental studies. American Journal of Respiratory and Critical Care Medicine. ,vol. 157, pp. 294- 323 ,(1998) , 10.1164/AJRCCM.157.1.9604014