Feihl François, Broccard Alain F
Division of Clinical Pathophysiology, University Hospital (CHUV) and Lausanne University (UNIL), 1011, Lausanne, Switzerland.
Intensive Care Med. 2009 Jan;35(1):45-54. doi: 10.1007/s00134-008-1297-z. Epub 2008 Sep 30.
The topic of cardiorespiratory interactions is of extreme importance to the practicing intensivist. It also has a reputation for being intellectually challenging, due in part to the enormous volume of relevant, at times contradictory literature. Another source of difficulty is the need to simultaneously consider the interrelated functioning of several organ systems (not necessarily limited to the heart and lung), in other words, to adopt a systemic (as opposed to analytic) point of view. We believe that the proper understanding of a few simple physiological concepts is of great help in organizing knowledge in this field. The first part of this review will be devoted to demonstrating this point. The second part, to be published in a coming issue of Intensive Care Medicine, will apply these concepts to clinical situations. We hope that this text will be of some use, especially to intensivists in training, to demystify a field that many find intimidating.
心肺相互作用的话题对于执业重症监护医生极为重要。它也因在智力上具有挑战性而闻名,部分原因在于相关文献数量庞大,且有时相互矛盾。另一个困难来源是需要同时考虑多个器官系统(不一定局限于心脏和肺)的相互关联功能,换句话说,要采用系统(而非分析)的观点。我们认为,正确理解一些简单的生理概念对整理该领域的知识有很大帮助。本综述的第一部分将致力于阐述这一点。第二部分将发表在即将出版的《重症医学》杂志上,会将这些概念应用于临床情况。我们希望本文会有所帮助,尤其是对正在接受培训的重症监护医生,以使这个许多人觉得令人生畏的领域不再神秘。