Challenges in Transitioning from Controlled to Assisted Ventilation in Acute Respiratory Distress Syndrome (ARDS) Management

被引:0
|
作者
Battaglini, Denise [1 ,2 ]
Rocco, Patricia R. M. [3 ]
机构
[1] Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, I-16132 Genoa, Italy
[2] IRCCS Osped Policlin San Martino, Anesthesia & Intens Care, I-16132 Genoa, Italy
[3] Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,373,Bloco G-014, BR-21941598 Rio De Janeiro, RJ, Brazil
关键词
ARDS; weaning; mechanical ventilation; transitioning; assisted ventilation; pressure support ventilation; controlled ventilation; END-EXPIRATORY PRESSURE; INFLICTED LUNG INJURY; INTENSIVE-CARE UNITS; MECHANICAL VENTILATION; TRANSPULMONARY PRESSURE; WEANING FAILURE; ISOFLURANE; SEDATION; SUPPORT; MODEL;
D O I
10.3390/jcm13237333
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Acute respiratory distress syndrome (ARDS) presents significant challenges in critical care, primarily due to its inflammatory nature, which leads to impaired gas exchange and respiratory mechanics. While mechanical ventilation (MV) is essential for patient support, the transition from controlled to assisted ventilation is complex and may be associated with intensive care unit-acquired weakness, ventilator-induced diaphragmatic dysfunction and patient self-inflicted lung injury. This paper explores the multifaceted challenges encountered during this transition, with a focus on respiratory effort, sedation management, and monitoring techniques, and investigates innovative approaches to enhance patient outcomes. The key strategies include optimizing sedation protocols, employing advanced monitoring methods like esophageal pressure measurements, and implementing partial neuromuscular blockade to prevent excessive respiratory effort. We also emphasize the importance of personalized treatment plans and the integration of artificial intelligence to facilitate timely transitions. By highlighting early rehabilitation techniques, continuously assessing the respiratory drive, and fostering collaboration among multidisciplinary teams, clinicians can improve the transition from controlled to assisted MV, ultimately enhancing recovery and long-term respiratory health in patients with ARDS.
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页数:12
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