机械通气在急性呼吸窘迫综合征中的应用进展

在治疗急性呼吸窘迫综合征的各种手段中,呼吸机机械通气是至关重要的.各种机械通气方式及参数的设置对于改善患者预后极为重要.从现有的研究资料来看,小潮气量机械通气(<6 ml/kg预计体质量,并使平台压小于30 cm H_2O)能减少死亡率,是急性呼吸窘迫综合征治疗的标准疗法.而个体化的呼气末正压通气也是一个有前途的值得研究的方向.其他一些方法例如俯卧位通气、肺复张等不能作为常规的一线治疗,而只能作为严重情况下低氧血症的挽救治疗.另外本文也就机械通气在2009年甲型H1N1流感所致急性呼吸窘迫综合征的治疗方面做了简单综述.

Application progress of mechanical ventilation in acute respiratory distress syndrome

Mechanical ventilation is essential in the treatment of acute respiratory distress syndrome(ARDS).Mechanical ventilation mode and parameter set are extremely important for improving the prognosis of patients.Research data have shown that low tidal volume ventilation(＜ 6 ml/kg predicted body weight,and plateau pressure is less than 30 cm H_2O)can reduce mortality and is standard treatment for ARDS.The individualized positive end expiratory pressure ventilation is also a promising study direction.Other methods such as prone position ventilation,alveolar recruitment can not be used as routine first-line treatment,but only be used.as rescue treatment under severe hypoxemia.Additionally,this article also reviews some characteristics of mechanical ventilation on the treatment of ARDS induced by H1N1 influenza in 2009.