重症监护病房的基石：高频通气将持续存在。
ICU cornerstone: high frequency ventilation is here to stay.
作者信息
Rimensberger Peter C
机构信息
Pediatric and Neonatal ICU, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland.
出版信息
Crit Care. 2003 Oct;7(5):342-4. doi: 10.1186/cc2327. Epub 2003 Jul 2.
Abstract
With favourable and extensive experience in the neonatal intensive care unit (ICU) and the recent positive experience in the adult ICU, high-frequency ventilation has become a valuable alternative to conventional ventilation in acute lung injury. To arrive at this point, physicians' understanding of the characteristics and kinetics of acute lung injury had to become more distinct, and it was necessary to merge accumulated knowledge from experience with high-frequency ventilation in the neonatal population and that with conventional ventilation in adults. However, this now calls for a better designed clinical trial in the adult population that combines the three most important concepts for lung protection: early intervention (before acute respiratory distress syndrome is established); optimal lung recruitment; and careful avoidance of lung over-distention over the entire period of mechanical ventilation.
摘要
鉴于在新生儿重症监护病房（ICU）积累的丰富且良好的经验，以及近期在成人ICU取得的积极经验，高频通气已成为急性肺损伤中传统通气的一种有价值的替代方法。要达到这一步，医生对急性肺损伤的特征和动力学的理解必须更加清晰，而且有必要将新生儿群体高频通气的经验积累与成人传统通气的经验积累相结合。然而，现在需要在成人中进行一项设计更完善的临床试验，该试验要结合肺保护的三个最重要概念：早期干预（在急性呼吸窘迫综合征确立之前）；最佳肺复张；以及在整个机械通气期间小心避免肺过度扩张。
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