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本文引用的文献

1
Preliminary study of ventilation with 4 ml/kg tidal volume in acute respiratory distress syndrome: feasibility and effects on cyclic recruitment - derecruitment and hyperinflation.急性呼吸窘迫综合征中4ml/kg潮气量通气的初步研究:可行性及对周期性肺复张-萎陷和肺过度充气的影响
Crit Care. 2013 Jan 28;17(1):R16. doi: 10.1186/cc12487.
2
High-frequency oscillation in early acute respiratory distress syndrome.早期急性呼吸窘迫综合征中的高频振荡。
N Engl J Med. 2013 Feb 28;368(9):795-805. doi: 10.1056/NEJMoa1215554. Epub 2013 Jan 22.
3
High-frequency oscillation for acute respiratory distress syndrome.高频振荡治疗急性呼吸窘迫综合征。
N Engl J Med. 2013 Feb 28;368(9):806-13. doi: 10.1056/NEJMoa1215716. Epub 2013 Jan 22.
4
The new definition for acute lung injury and acute respiratory distress syndrome: is there room for improvement?急性肺损伤和急性呼吸窘迫综合征的新定义:是否有改进的空间?
Curr Opin Crit Care. 2013 Feb;19(1):16-23. doi: 10.1097/MCC.0b013e32835c50b1.
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Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study.肺保护性机械通气与急性肺损伤患者的两年生存率:前瞻性队列研究。
BMJ. 2012 Apr 5;344:e2124. doi: 10.1136/bmj.e2124.
6
Is there an optimal breath pattern to minimize stress and strain during mechanical ventilation?在机械通气期间,是否存在一种能将压力和应变降至最低的最佳呼吸模式?
Intensive Care Med. 2009 Aug;35(8):1479-83. doi: 10.1007/s00134-009-1510-8. Epub 2009 Jun 20.
7
CO2 elimination at varying inspiratory pause in acute lung injury.急性肺损伤中不同吸气暂停时的二氧化碳清除
Clin Physiol Funct Imaging. 2007 Jan;27(1):2-6. doi: 10.1111/j.1475-097X.2007.00699.x.
8
Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome.肺死腔分数作为急性呼吸窘迫综合征死亡的危险因素。
N Engl J Med. 2002 Apr 25;346(17):1281-6. doi: 10.1056/NEJMoa012835.
9
Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs.低潮气量可减轻酸损伤大鼠肺组织的上皮和内皮损伤。
Am J Respir Crit Care Med. 2002 Jan 15;165(2):242-9. doi: 10.1164/ajrccm.165.2.2108087.
10
Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome.压力控制反比通气与体外二氧化碳清除治疗成人呼吸窘迫综合征的随机临床试验
Am J Respir Crit Care Med. 1994 Feb;149(2 Pt 1):295-305. doi: 10.1164/ajrccm.149.2.8306022.

超保护性潮气量:我们应降至多低?

Ultra-protective tidal volume: how low should we go?

作者信息

Costa Eduardo L V, Amato Marcelo B P

出版信息

Crit Care. 2013 Mar 28;17(2):127. doi: 10.1186/cc12556.

DOI:10.1186/cc12556
PMID:23551995
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3672527/
Abstract

Applying tidal volumes of less than 6 mL/kg might improve lung protection in patients with acute respiratory distress syndrome. In a recent article, Retamal and colleagues showed that such a reduction is feasible with conventional mechanical ventilation and leads to less tidal recruitment and overdistension without causing carbon dioxide retention or auto-positive end-expiratory pressure. However, whether the compensatory increase in the respiratory rate blunts the lung protection remains unestablished.

摘要

应用小于6 mL/kg的潮气量可能会改善急性呼吸窘迫综合征患者的肺保护。在最近的一篇文章中,雷塔马尔及其同事表明,采用传统机械通气减少潮气量是可行的,并且可减少潮气量导致的肺复张和过度扩张,同时不会引起二氧化碳潴留或内源性呼气末正压。然而,呼吸频率的代偿性增加是否会削弱肺保护作用仍未明确。