Pham Tài, Brochard Laurent J, Slutsky Arthur S
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
Mayo Clin Proc. 2017 Sep;92(9):1382-1400. doi: 10.1016/j.mayocp.2017.05.004.
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs. We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. Finally, we discuss the future of mechanical ventilation, addressing avenues for improvement.
机械通气是全球使用最广泛的短期生命支持技术，每天用于各种不同的适应症，从预定的外科手术到急性器官衰竭。这篇综述提供了呼吸力学的基本生理学、工作原理、主要通气设置以及机械通气潜在并发症的最新信息。详细介绍了急性呼吸窘迫综合征和慢性阻塞性肺疾病等特定情况下的具体通气方法以及正常肺患者的保护性通气。我们还强调了关于患者-呼吸机不同步、经鼻高流量湿化氧疗、体外生命支持和撤机阶段的最新数据。最后，我们讨论了机械通气的未来，探讨改进的途径。
