Interdepartmental Division of Critical Care Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada.
Department of Respiratory Therapy, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
Crit Care Clin. 2018 Jul;34(3):325-341. doi: 10.1016/j.ccc.2018.03.008.
Poor synchrony between the delivery of mechanical breaths, the neural respiratory timing, and needs of patients is relatively frequent under mechanical ventilation in the intensive care unit. This review summarizes the current knowledge on the different types of dyssynchrony described to date, their mechanism, consequences, and potential management. There is still a long way to get to a comprehensive knowledge and uncertainties remain. Ongoing research and development of monitoring tools are urgently needed to allow a better appraisal of this area in a near future.
在重症监护病房中,机械通气时机械通气与神经呼吸节律及患者需求之间的同步性较差相对较为常见。本篇综述总结了目前对不同类型的失同步的认识,包括其发生机制、后果和潜在的处理方法。要全面了解这一问题,还有很长的路要走,仍然存在许多不确定性。目前迫切需要进行监测工具的研究和开发,以便在不久的将来能够更好地评估这一领域。