气道压力释放通气治疗急性肺损伤和急性呼吸窘迫综合征的研究进展

气道压力释放通气是以持续气道正压为工作基础的压力控制机械通气模式,其从高气道压向低气道压释放压力产生通气量进行气体交换.它能在肺保护通气策略基础上维持肺复张、开放及减少呼吸机相关肺损伤.它对急性肺损伤/急性呼吸窘迫综合征患者在降低气道峰压及平均压、提高氧合、改善血流动力学和胃肠灌注、减少镇静和麻醉药物使用等方面产生广泛有利影响;而且,自主呼吸对重力依赖区塌陷肺组织的重新开放在其中发挥重要作用,其应用受到研究者和临床医师越来越多的关注.

Research advance of airway pressure release ventilation in treatment of ALI/ARDS

Airway pressure release ventilation (APRV) is pressure controlled mechanical ventilation on the base of continuous positive airway pressure,and accomplishs ventilatory capacity for gas exchange by releasing pressure from high airway pressure to low airway pressure. It can sustain lung recruitment and reduce ventilator associated lung injury on the base of lung protective ventilatory strategies. APRV has many advantageous influence in decreasing airway pressures, improving oxygenation,improvements in hemodynamics and gastrointestinal perfusion, reducing sedation/anesthetics requirements in ventilatory support in the presence of acute lung injury/acute respiratory distress syndrome. Moreover, spontaneous breathing plays an important role in recruiting dependent collapsed lung regions throughout the entire ventilatory cycle. So,researchers and doctors pay more and more attention to APRV.