Singh Abhijeet, Gupta Ayush, Sen Manas Kamal, Suri Jagdish Chander, Chakrabarti Shibdas, Bhattacharya Dipak
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Lung India. 2019 Sep-Oct;36(5):451-456. doi: 10.4103/lungindia.lungindia_330_17.
Lung recruitment maneuvers are rescue measures commonly used to improve oxygenation in severely hypoxemic patients with acute respiratory distress syndrome (ARDS), who fail to improve on standard treatment. After recruitment, appropriate level of positive end-expiratory pressure (PEEP) is applied to prevent alveolar de-recruitment during expiration. Computed tomography scan of thorax and quasi-static pressure-volume curves have played a pivotal role are important in the assessment of recruitment, but they have several limitations. Lung ultrasound (LUS), which is now easily available in nearly every Intensive Care Unit, could be an attractive alternative method for assessing lung recruitment. It is noninvasive, easily repeatable and is devoid of radiation hazards. We are presenting a case of 24-year-old female patient with moderate ARDS in whom bedside LUS was successfully used into assessing lung recruitment as well as into determining the appropriate level of PEEP.
肺复张手法是常用于改善急性呼吸窘迫综合征(ARDS)严重低氧血症患者氧合的抢救措施,这些患者在标准治疗下病情无改善。复张后,应用适当水平的呼气末正压(PEEP)以防止呼气时肺泡再萎陷。胸部计算机断层扫描和准静态压力-容积曲线在评估复张中发挥了关键作用,但它们有一些局限性。肺超声(LUS)现在几乎在每个重症监护病房都很容易获得,可能是评估肺复张的一种有吸引力的替代方法。它是非侵入性的,易于重复,且无辐射危害。我们报告一例24岁中度ARDS女性患者,床边肺超声成功用于评估肺复张以及确定合适的PEEP水平。