Ambrosino N, Nava S, Rubini F
Fondazione Clinica del Lavoro IRCCS, Centro Medico di Montescano, Pavia, Italy.
Monaldi Arch Chest Dis. 1993;48(2):144-54.
Acute respiratory failure is usually managed by means of mechanical ventilation via an endotracheal tube or tracheostomy, when conservative treatment fails. Invasive mechanical ventilation is associated with several complications. The recent development of non-invasive methods of ventilation, has led to an attempt to avoid the complications of invasive mechanical ventilation during episodes of acute respiratory failure, ensuring at the same time a similar degree of efficacy. Both intermittent negative pressure ventilation and positive pressure ventilation by face or nasal mask have recently been used for this purpose. Negative pressure ventilation by means of iron lung, cuirass or poncho-wrap ventilators, has never been used in place of endotracheal intubation, and studies of this kind of ventilation are inconclusive: as a consequence, there is, at the moment, no indication for the generalized use of negative pressure ventilation in acute respiratory failure. Intermittent positive pressure ventilation by facial or nasal masks, has recently been used in the treatment of respiratory failure in place of endotracheal intubation. The results are promising, but remain controversial. It may be attempted in selected patients with obstructive respiratory disorders, but the procedure is very time-consuming for nurses.
急性呼吸衰竭在保守治疗无效时，通常通过气管内插管或气管切开进行机械通气来处理。有创机械通气会引发多种并发症。无创通气方法的最新进展，促使人们尝试在急性呼吸衰竭发作期间避免有创机械通气的并发症，同时确保相似的疗效。间歇性负压通气以及通过面罩或鼻罩进行的正压通气最近都被用于此目的。借助铁肺、胸甲式或雨披式呼吸机进行的负压通气从未被用于替代气管内插管，并且这类通气的研究尚无定论：因此，目前没有迹象表明负压通气可广泛用于急性呼吸衰竭。通过面罩或鼻罩进行的间歇性正压通气最近已被用于替代气管内插管治疗呼吸衰竭。结果很有前景，但仍存在争议。对于选定的阻塞性呼吸障碍患者可以尝试，但该操作对护士来说非常耗时。
