Benson Alexander B, Albert Richard K
University of Colorado, 12605 E, 16th avenue, Aurora, CO 80045, USA; Department of Medicine, Denver Health, 777 Bannock, MC 4000, Denver, CO 80204-4507, USA.
University of Colorado, 12605 E, 16th avenue, Aurora, CO 80045, USA; Department of Medicine, Denver Health, 777 Bannock, MC 4000, Denver, CO 80204-4507, USA.
Clin Chest Med. 2014 Dec;35(4):743-52. doi: 10.1016/j.ccm.2014.08.011. Epub 2014 Sep 26.
Multiple animal and human studies have shown that prone positioning improves oxygenation and reduces ventilator-induced lung injury (VILI) in the setting of acute lung injury or acute respiratory distress syndrome (ARDS). In this article, the physiologic changes explaining the improvement in oxygenation are reviewed, how prone positioning reduces VILI is described, randomized controlled trials of prone ventilation in patients with ARDS are evaluated, the complications associated with prone ventilation are summarized, suggestions are made as to how these might be reduced or avoided, and when prone ventilation should start and stop and for what duration it should be used are discussed.
多项动物和人体研究表明，在急性肺损伤或急性呼吸窘迫综合征（ARDS）情况下，俯卧位可改善氧合并减少呼吸机诱导的肺损伤（VILI）。本文回顾了解释氧合改善的生理变化，描述了俯卧位如何减少VILI，评估了ARDS患者俯卧通气的随机对照试验，总结了与俯卧通气相关的并发症，就如何减少或避免这些并发症提出了建议，并讨论了俯卧通气应何时开始和停止以及应使用多长时间。
