Hickling Keith G
Department of Intensive Care, Gold Coast Hospital, Southport, Queensland, Australia.
Curr Opin Crit Care. 2002 Feb;8(1):32-8. doi: 10.1097/00075198-200202000-00006.
New evidence requires a reinterpretation of the inflation pressure-volume curve and suggests that neither the lower nor the upper inflection point provides reliable information to determine safe ventilator settings in the acute respiratory distress syndrome. Recruitment probably continues throughout the inflation pressure-volume curve, and studies of the deflation pressure-volume curve, reinflations after partial deflation, or decremental positive end-expiratory pressure trials after a recruitment maneuver are probably needed to determine open-lung positive end-expiratory pressure.
新证据需要对充气压力-容积曲线进行重新解读，并表明在急性呼吸窘迫综合征中，无论是下拐点还是上拐点都无法提供可靠信息来确定安全的呼吸机设置。在整个充气压力-容积曲线上可能都存在肺复张过程，可能需要研究呼气压力-容积曲线、部分呼气后的再充气情况或肺复张操作后的递减呼气末正压试验，以确定开放肺呼气末正压。
