Cammarota Gianmaria, Simonte Rachele, Longhini Federico, Spadaro Savino, Vetrugno Luigi, De Robertis Edoardo
Department of Medicine and Surgery, Università degli Studi di Perugia, Perugia, Italy.
Department of Medical and Surgical Science, Università della Magna Graecia, Catanzaro, Italy.
Anesthesiology. 2023 Mar 1;138(3):317-334. doi: 10.1097/ALN.0000000000004480.
Advanced respiratory monitoring involves several mini- or noninvasive tools, applicable at bedside, focused on assessing lung aeration and morphology, lung recruitment and overdistention, ventilation-perfusion distribution, inspiratory effort, respiratory drive, respiratory muscle contraction, and patient-ventilator asynchrony, in dealing with acute respiratory failure. Compared to a conventional approach, advanced respiratory monitoring has the potential to provide more insights into the pathologic modifications of lung aeration induced by the underlying disease, follow the response to therapies, and support clinicians in setting up a respiratory support strategy aimed at protecting the lung and respiratory muscles. Thus, in the clinical management of the acute respiratory failure, advanced respiratory monitoring could play a key role when a therapeutic strategy, relying on individualization of the treatments, is adopted.
先进的呼吸监测涉及多种微型或非侵入性工具,可在床边使用,重点是评估肺通气和形态、肺复张和过度扩张、通气-灌注分布、吸气努力、呼吸驱动、呼吸肌收缩以及患者-呼吸机不同步,以应对急性呼吸衰竭。与传统方法相比,先进的呼吸监测有可能更深入地了解潜在疾病引起的肺通气病理改变,跟踪治疗反应,并支持临床医生制定旨在保护肺和呼吸肌的呼吸支持策略。因此,在急性呼吸衰竭的临床管理中,当采用依赖于个体化治疗的治疗策略时,先进的呼吸监测可能发挥关键作用。