Blanch Lluis, López-Aguilar Josefina, Villagrá Ana
Critical Care Center, Hospital de Sabadell, Institut Universitari Fundació Parc Taulí, Universitat Autónoma de Barcelona, Sabadell, Spain.
Curr Opin Crit Care. 2007 Jun;13(3):332-7. doi: 10.1097/MCC.0b013e32811e14f2.
To describe the physiologic and diagnostic utility of static pressure-volume curves of the respiratory system at the bedside in patients with acute lung injury or acute respiratory distress syndrome.
The pressure-volume curve of the respiratory system is a useful tool for the measurement of respiratory system mechanics in patients with acute lung injury or acute respiratory distress syndrome. The pressure-volume curve has a sigmoid shape, with lower and upper points on the inspiratory limb and a point of maximum curvature on the expiratory limb. Visual and mathematical pressure-volume curve analysis may be useful for understanding individual lung mechanics and for selecting ventilator settings. Among the different techniques for acquiring pressure-volume curves at the bedside, the constant slow flow method is the simplest to perform, the most clinically reliable and has the fewest limitations.
Measurement of pressure-volume curves at the bedside in critically ill patients with acute lung injury or acute respiratory distress syndrome should be considered a useful respiratory monitoring tool to assess physiologic lung status and to adjust ventilator settings, when appropriate, to minimize superimposed lung injury associated with mechanical ventilators.
描述急性肺损伤或急性呼吸窘迫综合征患者床边呼吸系统静态压力-容积曲线的生理及诊断价值。
呼吸系统压力-容积曲线是测量急性肺损伤或急性呼吸窘迫综合征患者呼吸系统力学的有用工具。压力-容积曲线呈S形，吸气支有上下两点，呼气支有最大曲率点。视觉和数学压力-容积曲线分析可能有助于理解个体肺力学及选择呼吸机设置。在床边获取压力-容积曲线的不同技术中，恒速慢流法操作最简单、临床最可靠且局限性最少。
对于患有急性肺损伤或急性呼吸窘迫综合征的危重症患者，床边测量压力-容积曲线应被视为一种有用的呼吸监测工具，以评估肺生理状态，并在适当的时候调整呼吸机设置，以尽量减少与机械通气相关的叠加性肺损伤。
