Amato Marcelo B P, Carvalho Carlos R R, Vieira Sílvia, Isola Alexandre, Rotman Vivian, Moock Marcelo, José Anderson, Franca Suelene Aires
UTI-Respiratória, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP.
Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, RS.
Rev Bras Ter Intensiva. 2007 Sep;19(3):374-83.
The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Acute Respiratory Distress Syndrome (ARDS) has been one of the updated topics. This objective was described the most important topics related to mechanical ventilation in patients with acute respiratory distress syndrome.
Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words mechanical ventilation and acute respiratory distress syndrome.
Recommendations on the use of lung protective strategies during mechanical ventilation based on reduced tidal volumes and limitation of plateau pressure. The state of the art of recruitment maneuvers and PEEP titration is also discussed.
The mechanical ventilation of patients with ADRS changed in the last few years. We presented the role of lung protective strategies that could be applied to these patients.
第二届巴西机械通气共识会议于2000年发布。自那时起，机械通气领域的知识迅速发展，大量临床研究得以发表，这些研究可能对危重症患者的通气管理产生影响。此外，循证医学不断发展的理念决定了根据临床推荐所基于研究的方法学价值对其进行分级。这种明确的方法拓宽了对临床推荐的理解与采用。出于这些原因，巴西重症医学会（AMIB）和巴西肺脏病与胸科学会（SBPT）决定更新第二届巴西共识的推荐意见。急性呼吸窘迫综合征（ARDS）是更新的主题之一。本研究旨在描述与急性呼吸窘迫综合征患者机械通气相关的最重要主题。
使用关键词“机械通气”和“急性呼吸窘迫综合征”对已发表文献进行系统综述，并对研究进行证据水平分级。
基于减少潮气量和限制平台压提出了机械通气期间使用肺保护策略的推荐意见。还讨论了肺复张手法和呼气末正压（PEEP）滴定的最新情况。
过去几年中，急性呼吸窘迫综合征患者的机械通气发生了变化。我们阐述了可应用于这些患者的肺保护策略的作用。
