PDF(Pubmed)
Abstract：
Mechanical ventilation (MV) is an important strategy for improving the survival of patients with respiratory failure. However, MV is associated with aggravation of lung injury, with ventilator-induced lung injury (VILI) becoming a major concern. Thus, ventilation protection strategies have been developed to minimize complications from MV, with the goal of relieving excessive breathing workload, improving gas exchange, and minimizing VILI. By opting for lower tidal volumes, clinicians seek to strike a balance between providing adequate ventilation to support gas exchange and preventing overdistension of the alveoli, which can contribute to lung injury. Additionally, other factors play a role in optimizing lung protection during MV, including adequate positive end-expiratory pressure levels, to maintain alveolar recruitment and prevent atelectasis as well as careful consideration of plateau pressures to avoid excessive stress on the lung parenchyma.
摘要：
机械通气(MV)是提高呼吸衰竭患者生存率的重要策略。然而,MV与肺损伤加重有关，呼吸机诱导的肺损伤（VILI）成为一个主要问题。因此，已经开发了通气保护策略，以最大程度地减少MV引起的并发症，为了减轻过度的呼吸负担，改善气体交换，最小化VILI。通过选择较低的潮气量，临床医生寻求在提供足够的通气以支持气体交换和防止肺泡过度扩张之间取得平衡，会导致肺损伤。此外,其他因素在MV期间优化肺保护作用，包括足够的呼气末正压水平，维持肺泡募集并防止肺不张，并仔细考虑高原压力，以避免对肺实质的过度压力。
