Bruells C S, Rossaint R, Dembinski R
Klinik für Anästhesiologie, Universitätsklinikum der RWTH Aachen, Pauwelsstrasse 30, Aachen, Germany.
Med Klin Intensivmed Notfmed. 2012 Nov;107(8):596-602. doi: 10.1007/s00063-012-0130-1. Epub 2012 Oct 25.
Ventilation of patients suffering from acute respiratory distress syndrome (ARDS) with protective ventilator settings is the standard in patient care. Besides the reduction of tidal volumes, the adjustment of a case-related positive end-expiratory pressure and preservation of spontaneous breathing activity at least 48 h after onset is part of this strategy. Bedside techniques have been developed to adapt ventilatory settings to the individual patient and the different stages of ARDS. This article reviews the pathophysiology of ARDS and ventilator-induced lung injury and presents current evidence-based strategies for ventilator settings in ARDS.
采用保护性通气设置对急性呼吸窘迫综合征（ARDS）患者进行通气是患者护理的标准做法。除了减少潮气量外，根据具体病例调整呼气末正压以及在发病后至少48小时保持自主呼吸活动也是该策略的一部分。已经开发出床边技术，以使通气设置适应个体患者和ARDS的不同阶段。本文综述了ARDS的病理生理学和呼吸机诱发的肺损伤，并介绍了目前基于证据的ARDS通气设置策略。
