Corbridge T C, Hall J B
Adult Special Care Unit, National Jewish Center for Immunology and Respiratory Medicine, Denver, USA.
J Crit Illn. 1994 Nov;9(11):1027-36.
In patients with obstructive lung disease, a strategy of mechanical ventilation that prolongs expiratory time and limits lung hyperinflation can decrease barotrauma. To prolong expiratory time, decrease minute ventilation and inspiratory time. Side effects of this strategy--high peak pressures and hypercapnia--are generally well tolerated. Additional goals for COPD patients include resting and strengthening respiratory muscles and decreasing load on the respiratory system. Short-acting benzodiazepines and morphine are effective for sedation and analgesia. Paralytic agents should be considered only if adequate control of the patient's cardiopulmonary status cannot be achieved by sedation alone.
在患有阻塞性肺病的患者中，延长呼气时间并限制肺过度充气的机械通气策略可减少气压伤。为延长呼气时间，可减少分钟通气量和吸气时间。该策略的副作用——高峰压和高碳酸血症——通常耐受性良好。慢性阻塞性肺疾病（COPD）患者的其他目标包括休息和增强呼吸肌以及减轻呼吸系统负荷。短效苯二氮䓬类药物和吗啡对镇静和镇痛有效。仅当仅通过镇静无法充分控制患者的心肺状态时才应考虑使用麻痹剂。
