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了解呼吸机引起的肺损伤:机械动力的作用
Stephan von Düring1, Ken Kuljit S Parhar2, Neill K J Adhikari3
1Division of Critical Care Medicine, Department of Acute Medicine, Geneva University Hospitals (HUG) and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.
机械功率是通风器引起的肺损伤 (VILI) 的综合指标,显示出有希望的结果. 需要进一步的研究来确定其因果关系和床边实施的最佳门.
科学领域:
- 关键护理医学 关键护理医学
- 肺部生理学 肺部生理学
背景情况:
- 机械通风对于呼吸衰竭至关重要,但有可能引起呼吸器引起的肺损伤 (VILI).
- 肺部保护性通风策略减少了,但没有消除与VILI相关的死亡率.
- 机械功率为VILI相关参数提供了一个统一的指标.
研究的目的:
- 审查机械动力在VILI中的作用.
- 探索其与患者结果的关联.
- 讨论实施的挑战和好处.
主要方法:
- 审查现有的动物和人类研究,将机械功率与VILI联系起来.
- 分析床边计算和门确定方面的挑战.
- 探索动态机械功率作为通用度量.
主要成果:
- 机械功率集成了多个VILI驱动参数 (体积,压力,流量,阻力,速率).
- 现有的研究表明,机械动力与VILI之间存在联系.
- 实际的临床实施受到计算复杂性和缺乏共识的限制.
结论:
- 机械功率是理解和潜在地减轻VILI的一个有希望的指标.
- 进一步的研究对于确定因果关系和定义最佳值至关重要.
- 动态机械动力可能提供一种更普遍适用的方法.
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