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驱动压指导通气策略的最新综述及其临床应用

An Updated Review of Driving-Pressure Guided Ventilation Strategy and Its Clinical Application.

机构信息

Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Biomed Res Int. 2022 Aug 2;2022:6236438. doi: 10.1155/2022/6236438. eCollection 2022.

Abstract

Traditional lung-protective ventilation strategies (LPVS) are currently used to reduce the incidence of postoperative pulmonary complications (PPCs), including low tidal volume (VT), positive end-expiratory pressure (PEEP), low inspiratory plateau pressure (Pplat), permissive hypercapnia, and recruitment maneuver (RM). However, a meta-analysis showed that high driving pressure was closely associated with the incidence of PPCs, but not with PEEP or VT, which led to the driving pressure-guided ventilation strategy. Some studies have proved that the driving pressure-guided ventilation strategy is superior to the traditional LPVS in reducing the incidence of PPCs. The purpose of this review is to present the current research progress and application of driving pressure-guided ventilation strategy.

摘要

传统的肺保护性通气策略(LPVS)目前用于降低术后肺部并发症(PPCs)的发生率,包括低潮气量(VT)、呼气末正压(PEEP)、低吸气平台压(Pplat)、允许性高碳酸血症和复张手法(RM)。然而,一项荟萃分析表明,高驱动压与 PPCs 的发生率密切相关,而与 PEEP 或 VT 无关,这导致了驱动压指导的通气策略。一些研究已经证明,驱动压指导的通气策略在降低 PPCs 的发生率方面优于传统的 LPVS。本综述的目的是介绍驱动压指导的通气策略的当前研究进展和应用。

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