Associated Health Professionals, Culver City, CA, USA.
Med Intensiva. 2013 May;37(4):292-8. doi: 10.1016/j.medin.2012.10.007. Epub 2012 Dec 20.
The first generation of mechanical ventilators were controlled and cycled by pressure. Unfortunately, they did not allow control of the delivered tidal volume under changes in the dynamics of the respiratory system. This led to a second generation of ventilators that allowed volume control, hence favoring the ventilatory strategy based on normalization of the arterial gases. Studies conducted in the 1980s which related lung injury to the high ventilator pressures utilized while treating acute respiratory distress syndrome patients renewed interest in pressure-controlled mechanical ventilation. In addition, new evidence became available, leading to the development of pulmonary protective strategies aiming at preventing the progression of ventilator-induced lung injury. This review provides a detailed description of the control of pressure or volume using certain ventilatory modes, and offers a general view of their advantages and disadvantages, based on the latest available evidence.
第一代机械呼吸机通过压力进行控制和循环。不幸的是，它们无法在呼吸系统动力学变化的情况下控制输送的潮气量。这导致了第二代允许容量控制的呼吸机的出现，从而有利于基于动脉气体正常化的通气策略。20 世纪 80 年代进行的研究将肺损伤与治疗急性呼吸窘迫综合征患者时使用的高呼吸机压力相关联，重新引起了对压力控制机械通气的兴趣。此外，新的证据出现了，导致开发了旨在防止呼吸机引起的肺损伤进展的肺保护性策略。本综述详细描述了使用某些通气模式控制压力或容量，并根据最新的可用证据概述了它们的优缺点。
