Strategies to reduce ventilator-associated lung injury (VALI)

被引：12

作者：

Salman, David ^{[1
]}

Finney, Simon J. ^{[1
]}

Griffiths, Mark J. D. ^{[1
]}

机构：

[1] Royal Brompton Hosp, Adult Intens Care Unit, London SW3 6NP, England

来源：

BURNS | 2013年 / 39卷 / 02期

关键词：

Acute lung injury (ALI); Acute respiratory distress syndrome (ARDS); Ventilator-associated lung injury (VALI); Clinical risk prediction; Biological markers; Positive-pressure respiration; Prone position ventilation; Extracorporeal membrane oxygenation (ECMO); High frequency oscillation/oscillatory ventilation (HFOV); Extracorporeal carbon dioxide removal (ECCO2R); RESPIRATORY-DISTRESS-SYNDROME; EXTRACORPOREAL MEMBRANE-OXYGENATION; FREQUENCY OSCILLATORY VENTILATION; POSITIVE-PRESSURE VENTILATION; TIDAL VOLUME VENTILATION; END-EXPIRATORY PRESSURE; HIGH AIRWAY PRESSURE; MECHANICAL VENTILATION; CLINICAL-OUTCOMES; PRONE POSITION;

D O I：

10.1016/j.burns.2012.10.013

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Optimal management of the acute respiratory distress syndrome (ARDS) requires prompt recognition, treatment of the underlying cause and the prevention of secondary injury. Ventilator-associated lung injury (VALI) is one of the several iatrogenic factors that can exacerbate lung injury and ARDS. Reduction of VALI by protective low tidal volume ventilation is one of the only interventions with a proven survival benefit in ARDS. There are, however, several factors inhibiting the widespread use of this technique in patients with established lung injury. Prevention of ARDS and VALI by detecting at-risk patients and implementing protective ventilation early is a feasible strategy. Detection of injurious ventilation itself is Possible, and potential biological markers of VALI have been investigated. Finally, facilitation of protective ventilation, including techniques such as extracorporeal support, can mitigate VALI. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.

引用

页码：200 / 211

页数：12

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