气道压力释放通气在急性呼吸窘迫综合征中的应用  

Airway pressure release ventilation in ARDS

作　　者：李文卓 刘硕 夏婧[1] 李美菊 杨莉[1] 柳金玲 钱传云[1] Li Wen-zhuo;Liu Shuo;Xia Jing;Li Mei-ju;Yang Li;Liu Jin-ling;Qian Chuan-yun(Department of Emergency,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院急救医学部,云南昆明650032

出　　处：《中国急救医学》2023年第3期247-252,共6页Chinese Journal of Critical Care Medicine

摘　　要：在小潮气量肺保护性通气时代,急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者的病死率仍高,机械通气参数设置不当会进一步增加呼吸机相关性肺损伤风险。由于ARDS患者肺泡的黏弹性,气道压力释放通气(airway pressure release ventilation, APRV)长时间的吸气、较高的压力以及短暂的释放可能更适合ARDS肺泡病理生理学变化。APRV有肺复张、稳定肺泡结构等优势,已经显示出作为一种肺保护通气策略的巨大潜力,本文将对APRV相关研究进展进行综述。In the era of low tidal volume lung protective ventilation, the mortality in ARDS patients remains high. Improper setting of mechanical ventilation parameters further increase the risk of ventilator-associated lung injury. The prolonged inspiration, higher pressure, and brief release of airway pressure release ventilation(APRV) may be more appropriate for the changes in alveolar pathophysiology in ARDS due to the viscoelasticity of the alveoli in ARDS patients. APRV has advantages such as lung recruitment, the stabilization of alveolar structures, and has shown great potential as a lung-protective ventilation strategy. In this paper, we review the progress of APRV-related researches.

关 键 词：急性呼吸窘迫综合征(ARDS) 气道压力释放通气(APRV) 时间控制适应性通气 呼吸机相关性肺损伤(VILI) 

分 类 号：R563.8[医药卫生—呼吸系统]