Caironi Pietro, Gattinoni Luciano
Istituto di Anestesiologia e Rianimazione, Dipartimento di Anestesia, Rianimazione e Terapia del Dolore, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano.
Recenti Prog Med. 2007 Oct;98(10):509-17.
Despite its wide application during mechanical ventilation of patients with acute respiratory distress syndrome, the correct setting of positive end-expiratory pressure is still an unsolved issue. We have recently observed that PEEP response is strictly correlated to the amount of the potentially recruitable lung, which is in turn associated to the overall severity of lung injury. Assessment of the potential for lung recruitment is therefore necessary for the correct setting of PEEP: a high PEEP level should be limited only to patients with a higher amount of potentially recruitable lung. At present, computed tomography represents the most accurate technique for its measurement.
尽管呼气末正压通气在急性呼吸窘迫综合征患者机械通气期间应用广泛，但呼气末正压的正确设置仍是一个未解决的问题。我们最近观察到，呼气末正压反应与潜在可复张肺组织的量密切相关，而潜在可复张肺组织的量又与肺损伤的总体严重程度相关。因此，正确设置呼气末正压需要评估肺复张的潜力：高呼气末正压水平应仅适用于潜在可复张肺组织量较多的患者。目前，计算机断层扫描是测量潜在可复张肺组织量最准确的技术。
