Dipartimento di Anestesiologia e Medicina degli Stati Critici, Università di Torino, Ospedale S. Giovanni Battista-Molinette, Torino, Italy.
Crit Care Med. 2010 Oct;38(10 Suppl):S555-8. doi: 10.1097/CCM.0b013e3181f20d5b.
Mechanical ventilation is a lifesaving treatment delivered to patients with a wide spectrum of medical and surgical diseases. However, significant limitations of the clinical application of mechanical ventilation in current practice have emerged, prompting the definition of novel therapeutic perspectives, especially concerning the prevention and treatment of acute respiratory failure. In the past few decades, there has been a consistent scientific and technologic effort to develop alternative strategies to avoid the need for mechanical ventilation. In particular, several studies have explored the feasibility and efficacy of extracorporeal oxygenation and carbon dioxide removal. Furthermore, promising results on the prevention of the occurrence of severe acute respiratory failure have been provided by clinical studies on the noninvasive application of continuous positive airway pressure as well as by experimental investigations in basic science. Therefore, further development in this direction will occur only with a permanent integration and exchange of knowledge among industry, clinicians, and scientific investigators.
机械通气是一种为患有广泛的内科和外科疾病的患者提供的救命治疗方法。然而,机械通气在目前的临床应用中存在显著的局限性,促使人们定义新的治疗观点,特别是在预防和治疗急性呼吸衰竭方面。在过去几十年中,人们一直在不断努力进行科学和技术创新,以开发替代策略来避免机械通气的需求。特别是,一些研究已经探索了体外氧合和二氧化碳去除的可行性和疗效。此外,对无创性应用持续气道正压通气的临床研究以及基础科学的实验研究为预防严重急性呼吸衰竭的发生提供了有希望的结果。因此,只有在工业界、临床医生和科学研究人员之间进行永久性的知识整合和交流,这一方向才会取得进一步的发展。