在手术后重症患者的保护性机械通风
Andres Zorrilla-Vaca1, Jimmy J Arevalo2, Michael C Grant3
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Current opinion in critical care
|November 6, 2024
概括
肺部保护性通风对于ICU中的手术患者至关重要. 像开放肺透气和个性化PEEP这样的策略可以减少呼吸器引起的肺损伤,并改善恢复.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 肺部医学 肺部医学
背景情况:
- 机械呼吸手术患者在重症监护室面临着挑战.
- 尽量减少呼吸器引起的肺损伤 (VILI) 和促进断奶是关键目标.
- 快速输出管道的协议显示了改善恢复和减少急性肺损伤的承诺.
研究的目的:
- 对重症手术患者的肺部保护策略进行审查.
- 评估在OR到ICU过渡期间开放肺通风的作用.
- 提供当前最佳实践的最新概述.
主要方法:
- 关于肺部保护通风的当前文献的综述.
- 分析开放肺透气策略,包括PEEP个性化和非侵入性通风.
- 专注于外科手术前期和ICU过渡.
主要成果:
- 快速排管可以改善恢复,减少肺损伤.
- 开放式肺透气,个性化PEEP和高流量鼻正在成为高风险患者的标准.
- 这些策略旨在尽量减少VILI和帮助断奶.
结论:
- 在手术患者的机械通风需要肺部保护策略.
- 个性化PEEP和优先考虑膜招募是必不可少的.
- 这些方法应在OR-to-ICU过渡期间实施.
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