Dries D J
Burn and Shock Trauma Institute, Loyola University Medical Center, Maywood, Illinois 60153, USA.
J Trauma. 1995 Nov;39(5):984-9. doi: 10.1097/00005373-199511000-00028.
Traditional practice of mechanical ventilation includes tactics to reduce lung injury, such as avoidance of excessive airway pressure, patient distress, and tidal volume. Gas exchange objectives have received priority, however, and a degree of lung injury has been accepted as inevitable. The current trend toward increasing use of permissive hypercapnia is based on the recognition that lung injury induced by mechanical ventilation may be reduced by compensated hypercapnia with few serious adverse effects and contraindications.
传统的机械通气方法包括一些减少肺损伤的策略,如避免气道压力过高、患者不适和潮气量过大。然而,气体交换目标一直是首要考虑的,一定程度的肺损伤被认为是不可避免的。目前越来越多地使用允许性高碳酸血症的趋势是基于这样一种认识,即机械通气引起的肺损伤可通过代偿性高碳酸血症来减轻,且几乎没有严重的不良反应和禁忌证。