David M, Werner C
Klinik für Anästhesiologie, Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131 Mainz, Deutschland.
Anaesthesist. 2007 May;56(5):485-90. doi: 10.1007/s00101-007-1167-z.
The concept of lung protective ventilation strategies is based on the limitation of the inspiratory pressure and the reduction of the tidal volume, in order to minimize the extent of breathing cycle-dependent damaging mechanisms from mechanical ventilation. This concept is coupled with various procedures for optimization of the end-expiratory lung volume in acute lung failure in order to improve the compromized oxygenation. In this situation high-frequency oscillatory ventilation (HFOV) has achieved a renaissance. Theoretically this procedure offers advantages which differentiates it from conventional ventilation procedures. The system allows the use of a constant higher mean airway pressure, a reduction of the peak pressure and the use of a tidal volume in the dead-space area. Very little data exist with respect to the application of this procedure in adult patients. For the clinical use of HFOV as a secondary procedure in adult patients suffering from acute lung failure it could be demonstrated that it is a safe and effective method of treatment. The effect of HFVO on the morbidity and mortality outcome, however, still needs to be characterized.
肺保护性通气策略的概念基于吸气压力的限制和潮气量的减少，以尽量减少机械通气中与呼吸周期相关的损伤机制的程度。这一概念与各种优化急性肺衰竭患者呼气末肺容积的方法相结合，以改善受损的氧合。在这种情况下，高频振荡通气（HFOV）得以复兴。从理论上讲，该方法具有一些优于传统通气方法的优点。该系统允许使用持续较高的平均气道压力，降低峰值压力，并在无效腔区域使用潮气量。关于该方法在成年患者中的应用，现有数据很少。对于在患有急性肺衰竭的成年患者中作为辅助方法临床使用HFOV，已证明它是一种安全有效的治疗方法。然而，高频振荡通气对发病率和死亡率结果的影响仍有待明确。
