Karsten J, Heinze H
Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Med Klin Intensivmed Notfmed. 2016 Mar;111(2):98-106. doi: 10.1007/s00063-015-0030-2. Epub 2015 May 14.
Both in the intensive care setting and during surgery, mechanical ventilation plays an important role in the treatment of critically ill patients with lung injury, but also in lung healthy patients. Mechanical ventilation is noncurative and is accompanied by various severe side effects. It is hypothesized that multiorgan failure can be induced by mechanical ventilation. Furthermore, there is evidence to suggest cross-talk between lungs and other organs. In particular, the activation of specific cells and cell programs in peripheral organs is an important step on the way to multiorgan failure. In addition to bidirectional connection between the lung and brain, nonprotective ventilation leads to cell apoptosis in the kidney and intestine and leads to an increase of biomarkers for organ dysfunction. It is believed that both inflammation mediators and pro-apoptotic factors are responsible for organ dysfunction.
在重症监护环境和手术过程中,机械通气在治疗肺损伤危重症患者以及肺健康患者方面都发挥着重要作用。机械通气并非治愈性手段,且伴有各种严重的副作用。据推测,机械通气可能会诱发多器官功能衰竭。此外,有证据表明肺与其他器官之间存在相互作用。特别是,外周器官中特定细胞和细胞程序的激活是走向多器官功能衰竭过程中的重要一步。除了肺与脑之间的双向联系外,非保护性通气会导致肾脏和肠道细胞凋亡,并导致器官功能障碍生物标志物增加。人们认为炎症介质和促凋亡因子均与器官功能障碍有关。