Department of Anesthesia and Intensive Care, Santa Chiara Hospital, Largo Medaglie d'Oro 9, Trento 38122, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Ateneo Nuovo Square, 1, Milan, Milan 20126, Italy; Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei Tintori, Via Giovanbattista Pergolesi 33, Monza, Lombardia 20900, Italy.
Clin Chest Med. 2024 Dec;45(4):849-861. doi: 10.1016/j.ccm.2024.08.006. Epub 2024 Sep 20.
Noninvasive respiratory supports have been successfully used as an alternative to endotracheal intubation especially in patients with a milder degree of hypoxemia. In patients with acute respiratory distress syndrome (ARDS), the main goals of noninvasive oxygenation strategies are to improve oxygenation, unload the respiratory muscles, and relieve dyspnea. On the other hand, recent studies have suggested that spontaneous breathing could represent an additional mechanism of lung injury, especially in the more severe forms. The aim of this review is to describe the role of different noninvasive respiratory supports in ARDS, to optimize its use in clinical practice.
无创性呼吸支持已成功应用于替代气管插管,尤其是在那些轻度低氧血症的患者中。在急性呼吸窘迫综合征(ARDS)患者中,无创氧合策略的主要目标是改善氧合、减轻呼吸肌负荷和缓解呼吸困难。另一方面,最近的研究表明,自主呼吸可能代表肺损伤的另一种机制,尤其是在更严重的情况下。本综述的目的是描述不同无创性呼吸支持在 ARDS 中的作用,以优化其在临床实践中的应用。