病人自己造成的肺损伤 - - 它真的存在吗?
Amal Jubran1, Franco Laghi, Martin J Tobin
1From the Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital, Hines, Illinois, Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois, USA.
Current opinion in critical care
|December 8, 2025
概括
患者自身造成的肺损伤 (P-SILI) 缺乏强有力的证据. 本综述批判性地检查了支持P-SILI的有限数据,质疑其在COVID-19肺损伤和呼吸机管理中的作用.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 机械通风机械通风机械通风
背景情况:
- 患者自我造成的肺损伤 (P-SILI) 是一种肺损伤的拟议机制.
- 该概念表明,患者产生的潮体积可能会导致气泡膜损伤.
研究的目的:
- 批判性地评估支持P-SILI存在的实验证据.
- 审查有关P-SILI在COVID-19肺损伤中的作用及其对呼吸机管理策略的影响的说法.
主要方法:
- 对P-SILI.现有的文献进行系统审查.
- 分析了P-SILI的支持者提出的论点和证据.
- 根据P-SILI的说法,审查COVID-19大流行期间的呼吸机管理建议.
主要成果:
- 审查发现缺乏可靠的实验数据来证实P-SILI的存在.
- 在COVID-19大流行期间,P-SILI与肺部损伤有争议,导致呼吸机管理发生了重大变化.
- 当被质疑时,P-SILI的支持者提供了令人信服的证据.
结论:
- 对P-SILI的说法是基于弱的间接证据.
- 证明负担在于那些声称P-SILI的人.
- 几十年来确立的通风机管理原则可能会根据未经证实的假设被推翻.
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