Algaba Á, Nin N
Unidad de Cuidados Intensivos, Hospital Universitario de Torrejón, Madrid, España.
Med Intensiva. 2013 Jun-Jul;37(5):355-62. doi: 10.1016/j.medin.2013.01.012. Epub 2013 Mar 23.
In patients with acute respiratory distress syndrome, heterogeneity in filling of the lung parenchyma results in collapsed or distended lung areas. Protective ventilation strategies based on the use of low volumes have been shown to increase survival in this context. For opening the lung, and in addition to PEEP, recruitment maneuvers are used-this practice remaining the subject of debate. The present review offers an update on the alveolar recruitment techniques, considering the great variability that exists in the application of these maneuvers, and the different factors that influence the response to maneuvering.
在急性呼吸窘迫综合征患者中,肺实质充盈的异质性导致肺区出现萎陷或膨胀。在这种情况下,基于小潮气量使用的肺保护性通气策略已被证明可提高生存率。为了使肺复张,除了使用呼气末正压通气(PEEP)外,还采用了肺复张手法——这种做法仍存在争议。本综述提供了关于肺泡复张技术的最新信息,考虑到这些手法应用中存在的巨大变异性,以及影响手法反应的不同因素。