Sun Xiumei, Wang Yumei, Yang Yanlin, Zhou Jianxin
Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. Corresponding author: Zhou Jianxin, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Dec;31(12):1549-1551. doi: 10.3760/cma.j.issn.2095-4352.2019.12.025.
The ventilator-induced lung injury (VILI) was centered on the "static" characteristics of the mechanical ventilation in early phases (tidal volume, plateau pressure, positive end-expiratory pressure and driving pressure). But the "dynamic" characteristics of ventilation must not be ignored (respiratory rate and flow). Mechanical energy and mechanical power (the pace of performing energy load) regarding all factor have won wide spread attention. The energy generated by mechanical ventilation is mainly used to expand respiratory system and overcome resistance, a fraction of energy acts on lung tissues probably inducing "heat" and inflammation that is related to lung injury. The review described recent conceptual advances regarding the mechanical energy and power, and the relationship with VILI, hoping to help further understanding the risk factors for VILI.
呼吸机诱导的肺损伤(VILI)在早期主要集中于机械通气的“静态”特征(潮气量、平台压、呼气末正压和驱动压)。但通气的“动态”特征(呼吸频率和流速)也不容忽视。关于所有这些因素的机械能和机械功率(执行能量负荷的速率)已受到广泛关注。机械通气产生的能量主要用于扩张呼吸系统和克服阻力,一部分能量作用于肺组织,可能会诱发与肺损伤相关的“热”和炎症。本文综述了关于机械能和功率的最新概念进展及其与VILI的关系,希望有助于进一步理解VILI的危险因素。