Lu Q, Rouby J J
Surgical Intensive Care Unit Pierre Viars, Department of Anesthesiology, La Pitié-Salpêtrière Hospital, University of Paris VI, France.
Minerva Anestesiol. 2000 May;66(5):367-75.
In critically ill patients measurements of pressure volume curves has been suggested as a method for assessing the severity of lung injury and for monitoring the evolution of the lung disease; it can also guide the ventilatory adjustments to optimize the mechanical ventilation. The static pressure-volume curves are impaired in acute respiratory distress syndrome (ARDS). The evaluation of the lower and upper inflection point on the pressure-volumes curves at the bedside of patients with acute respiratory failure means to apply a "protective ventilatory strategy". The combined application of positive end expiratory pressure (PEEP) to the level of alveolar recruitment and low tidal volume (< 6 ml/kg) ameliorates the lung function and decrease mortality in ARDS patients. Routine monitoring with continuous technique is easy and develops good therapeutic practice.
对于重症患者，有人建议测量压力-容积曲线，作为评估肺损伤严重程度和监测肺部疾病进展的一种方法；它还可以指导通气调整，以优化机械通气。急性呼吸窘迫综合征（ARDS）患者的静态压力-容积曲线受损。在急性呼吸衰竭患者床边评估压力-容积曲线上的下拐点和上拐点，意味着采用“保护性通气策略”。将呼气末正压（PEEP）应用到肺泡复张水平，并结合低潮气量（<6 ml/kg），可改善ARDS患者的肺功能并降低死亡率。采用连续技术进行常规监测简便易行，且能形成良好的治疗实践。
