Biselli Paolo Jose Cesare, Degobbi Tenorio Quirino Dos Santos Lopes Fernanda, Righetti Renato Fraga, Moriya Henrique Takachi, Tibério Iolanda Fátima Lopes Calvo, Martins Milton Arruda
Intensive Care Unit, University Hospital, University of Sao Paulo, Sao Paulo, Brazil.
Laboratory of Experimental Therapeutics, Department of Clinical Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Front Physiol. 2022 Jul 13;13:817263. doi: 10.3389/fphys.2022.817263. eCollection 2022.
Lung physiology research advanced significantly over the last 100 years. Respiratory mechanics applied to animal models of lung disease extended the knowledge of the workings of respiratory system. In human research, a better understanding of respiratory mechanics has contributed to development of mechanical ventilators. In this review, we explore the use of respiratory mechanics in basic science to investigate asthma and chronic obstructive pulmonary disease (COPD). We also discuss the use of lung mechanics in clinical care and its role on the development of modern mechanical ventilators. Additionally, we analyse some bench-developed technologies that are not in widespread use in the present but can become part of the clinical arsenal in the future. Finally, we explore some of the difficult questions that intensive care doctors still face when managing respiratory failure. Bringing back these questions to bench can help to solve them. Interaction between basic and translational science and human subject investigation can be very rewarding, as in the conceptualization of "Lung Protective Ventilation" principles. We expect this interaction to expand further generating new treatments and managing strategies for patients with respiratory disease.
在过去的100年里，肺生理学研究取得了显著进展。应用于肺部疾病动物模型的呼吸力学扩展了对呼吸系统工作原理的认识。在人体研究中，对呼吸力学的更好理解推动了机械通气机的发展。在本综述中，我们探讨了呼吸力学在基础科学中用于研究哮喘和慢性阻塞性肺疾病（COPD）的情况。我们还讨论了肺力学在临床护理中的应用及其在现代机械通气机发展中的作用。此外，我们分析了一些目前未广泛使用但未来可能成为临床手段一部分的实验室研发技术。最后，我们探讨了重症监护医生在处理呼吸衰竭时仍然面临的一些难题。将这些问题带回实验室有助于解决它们。基础科学与转化科学以及人体研究之间的相互作用可能会非常有成效，就像“肺保护性通气”原则的概念化过程一样。我们期望这种相互作用能进一步扩展，为呼吸系统疾病患者产生新的治疗方法和管理策略。
