Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2020 Jun;73(3):194-204. doi: 10.4097/kja.20041. Epub 2020 Feb 26.
Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and PEEP are not related to patient outcomes, or only related when they influence the driving pressure. Therefore, this review introduces the concept of driving pressure and looks into the possibility of driving pressure-guided ventilation as a new ventilatory strategy, especially in thoracic surgery where postoperative pulmonary complications are common, and thus, lung protection is of utmost importance.
保护性通气策略是目前主要的通气策略，包括小潮气量、限制吸气压力和应用呼气末正压（PEEP）。然而，最近的几项回顾性研究表明，潮气量、吸气压力和 PEEP 与患者预后无关，或者仅在影响驱动压时才相关。因此，本综述介绍了驱动压的概念，并探讨了驱动压指导通气作为一种新的通气策略的可能性，尤其是在胸外科，术后肺部并发症很常见，因此，肺保护至关重要。
