摘要
自主呼吸可能对ARDS患者有多种生理益处,包括减少镇静需求,保持膈肌活动和改善心血管功能。然而,剧烈的自主呼吸努力可能会加重肺损伤,2017年起,用力呼吸导致的肺损伤被称为“患者自戕性肺损伤(P-SILI)”。如何减轻ARDS P-SILI,让患者保持“安全”的自主呼吸成为临床医疗的研究热点。本文就呼吸驱动力在ARDS P-SILI中的生理和临床意义做一综述,并探讨评估呼吸驱动力的方法和改善P-SILI的措施,旨在为减轻ARDS患者的肺损伤提供理论依据,并为最新暴发的新型冠状病毒肺炎的治疗提供新思路。
Spontaneous breathing may offer multiple physiologic benefits for patients with ARDS,including decreased need for sedation,preserved diaphragm activity and improving cardiovascular function.However,vigorous spontaneous breathing efforts may aggravate lung injury.The effort-dependent lung injury has been termed'patient self-inflicted lung injury(P-SILI)'in 2017.How to prevent P-SILI in ARDS and keep'safe'spontaneous breathing become the research focus in clinical treatment.This article reviews the physiological and clinical significance of respiratory driving force in ARDS patients with self-inflicted lung injury,and discusses methods to evaluate respiratory driving force and measures to improve P-SILI,in order to provide theoretical basis for reducing lung injury in ARDS patients,and provide a new idea for the treatment of the latest outbreak of COVID-19.
作者
李晗
陈强
韩旭东
Li Han;Chen Qiang;Han Xudong(Department of Critical Care Medicine,Nantong Third Hospital Affiliated to Nantong University,Nantong 226000,China)
出处
《中华重症医学电子杂志》
CSCD
2021年第1期66-70,共5页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
基金
江苏省南通市卫健委市级重点学科支持项目(wx2017002)
江苏省南通市科技计划项目(MS12017004-2,MS12018040,XG202003-3)。
关键词
急性呼吸窘迫综合征
自主呼吸
自戕式肺损伤
呼吸驱动力
Acute respiratory distress syndrome
Spontaneous breathing
Self-inflicted lung injury
Respiratory drive
