Prone Positioning and Neuromuscular Blocking Agents as Adjunctive Therapies in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome

被引：2

作者：

Guerin, Claude ^{[1
,2
,3
]}

Cour, Martin ^{[1
,2
]}

Argaud, Laurent ^{[1
,2
]}

机构：

[1] Hop Edouard Herriot, Med Intens Reanimat, Lyon, France

[2] Univ Lyon, Fac Med Lyon Est, Lyon, France

[3] Inst Mondor Rech Blomed, INSERM CNRS 955 7200, Creteil, France

来源：

SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE | 2022年 / 43卷 / 03期

关键词：

acute respiratory distress syndrome; prone position; neuromuscular blocking agents; lung protective ventilation; COVID-19; COMPUTED-TOMOGRAPHIC DENSITY; GAS-EXCHANGE; SURVIVAL; COVID-19; FAILURE; DISEASE; OXYGENATION; IMPROVEMENT; PRESSURES; MORTALITY;

D O I：

10.1055/s-0042-1744304

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Neuromuscular blocking agents (NMBAs) and prone position (PP) are two major adjunctive therapies that can improve outcome in moderate-to-severe acute respiratory distress syndrome. NMBA should be used once lung-protective mechanical ventilation has been set, for 48 hours or less and as a continuous intravenous infusion. PP should be used as early as possible for long sessions; in COVID-19 its use has exploded. In nonintubated patients, PP might reduce the rate of intubation but not mortality. The goal of this article is to perform a narrative review on the pathophysiological rationale, the clinical effects, and the clinical use and recommendations of both NMBA and PP.

引用

页码：453 / 460

页数：8

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