van Heerden P V, Jacob W, Cameron P D, Webb S
Dept of Intensive Care, Sir Charles Gairdner Hospital, Nedlands, W.A.
Anaesth Intensive Care. 1995 Apr;23(2):175-7. doi: 10.1177/0310057X9502300208.
Segmental and lobar pulmonary atelectasis is a common occurrence in mechanically ventilated patients. Standard therapy for atelectasis relies on positive pressure ventilation, positive and expiratory pressure (PEEP), tracheobronchial toilet and regular chest physiotherapy. Various adjuncts to physiotherapy such as bronchoscopic clearance of secretions have not proved to be of additional benefit. Bronchoscopic clearance of secretions followed by insufflation of room air at 30 cm H2O into the atelectatic segment was employed on ten occasions in mechanically ventilated patients. Rapid re-expansion of the collapsed segment or lobe occurred in seven out of the ten treatments.
节段性和大叶性肺不张在机械通气患者中很常见。肺不张的标准治疗依赖于正压通气、呼气末正压(PEEP)、气管支气管清理和常规胸部物理治疗。各种物理治疗辅助手段,如支气管镜清除分泌物,尚未证明有额外益处。在机械通气患者中,有十次采用了支气管镜清除分泌物,然后以30 cm H2O的压力向肺不张节段吹入室内空气。十次治疗中有七次出现塌陷节段或肺叶迅速复张。