高频振荡通气在烧伤和创伤 ICU 患者中的应用综述。
A review of the utility of high-frequency oscillatory ventilation in burn and trauma ICU patients.
机构信息
Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Department of Emergency Medicine, Department of Anesthesia & Critical Care Medicine.
出版信息
Curr Opin Anaesthesiol. 2023 Apr 1;36(2):126-131. doi: 10.1097/ACO.0000000000001228. Epub 2022 Dec 22.
PURPOSE OF REVIEW
The purpose was to examine the utility of high-frequency oscillatory ventilation (HFOV) in trauma and burn ICU patients who require mechanical ventilation, and provide recommendations on its use.
RECENT FINDINGS
HFOV may be beneficial in burn patients with smoke inhalation injury with or without acute lung injury/acute respiratory distress syndrome (ARDS), as it improves oxygenation and minimizes ventilator-induced lung injury. It also may have a role in improving oxygenation in trauma patients with blast lung injury, pulmonary contusions, pneumothorax with massive air leak, and ARDS; however, the mortality benefit is unknown.
SUMMARY
Although some studies have shown promise and improved outcomes associated with HFOV, we recommend its use as a rescue modality for patients who have failed conventional ventilation.
目的综述
目的在于探讨高频振荡通气（HFOV）在需要机械通气的创伤和烧伤 ICU 患者中的应用价值，并就其应用提供建议。
最新发现
HFOV 可能对伴有或不伴有急性肺损伤/急性呼吸窘迫综合征（ARDS）的吸入性烧伤患者有益，因为它可以改善氧合并最大限度地减少呼吸机引起的肺损伤。它在改善因爆炸伤、肺挫伤、气胸伴大量漏气和 ARDS 导致的氧合的创伤患者中也可能有作用；但是，其死亡率获益尚不清楚。
总结
虽然一些研究表明 HFOV 具有应用前景并能改善结局，但我们建议将其作为常规通气失败患者的抢救手段。
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