急性呼吸困难综合征患者的机械通风:目前的状况和未来的前景
Denise Battaglini1, Ida Giorgia Iavarone1,2, Chiara Robba1,2
1Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Expert review of medical devices
|September 5, 2023
概括
针对急性呼吸窘迫综合征 (ARDS) 的机械通风需要个性化策略. 虽然新模式显示出希望,但目前的指导方针不支持救援疗法,强调需要进一步研究ARDS管理.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 机械通风对于急性呼吸困难综合征 (ARDS) 主要是支持性的.
- 对于ARDS的新兴呼吸模式缺乏明确的临床影响和指南支持.
- 目前对ARDS的治疗策略仍然在很大程度上支持,尽管进行了广泛的研究.
研究的目的:
- 为ARDS患者提供机械通风策略的全面概述和更新.
- 审查有关ARDS的通风器设置,通风模式和救援策略的当前文献.
- 分析ARDS管理中先进干预措施的证据.
主要方法:
- 现有文献的叙述性审查.
- 在PubMed,EBSCO和Cochrane图书馆进行文献搜索,截至2023年6月.
- 分析主要的通风器参数,通风模式和救援策略.
主要成果:
- 根据目前的ARDS证据,个性化机械通风策略是建议的.
- 新的辅助机械通风模式正在研究中,尚未成为标准的护理.
- 在指导方针中,不建议采用招募机动和ECMO等救援策略作为标准护理.
结论:
- 需要进一步的研究来确定新型机械通风方法在ARDS中的有效性.
- 推个性化机械通风,但高级模式和救援策略需要更多的研究.
- 目前的指导方针不支持对ARDS患者的常规使用救援策略.
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