如何准确实施俯卧位与俯卧位通气  

How to implement prone position and prone ventilation accurately

作　　者：高心晶[1] 秦英智[1] Gao Xinjing;Qin Yingzhi(Department of Critical Care Medicine,Tianjin Third Central Hospital,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院重症医学科,天津300170

出　　处：《中国中西医结合急救杂志》2024年第4期396-400,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：俯卧位和俯卧位通气是拯救某些难治性低氧血症患者的有效方法,目前俯卧位已成为急性呼吸窘迫综合征(ARDS)的标准治疗手段.临床在实施俯卧位和俯卧位通气时首先应明确改善氧合的机制及对血流动力学的影响;使用俯卧位在保护性通气的同时应关注影响通气、氧合的常见因素,如呼吸力学的变化、腹内压(IAP)、血流动力学的变化.必须认识到俯卧位的临床应用在诸多方面尚未达成共识,导致急性低氧呼吸衰竭的病因、病情复杂,应准确评估.在规范应用俯卧位与俯卧位通气改善氧合的同时及时采用多种手段才能提高危重症患者的抢救成功率.Prone position and position ventilation(PPV)are effective methods to save patients with refractory hypoxemia,and prone position has become the standard treatment for acute respiratory distress syndrome(ARDS).Successful clinical implementation requires understanding the mechanisms improving oxygenation and hemodynamic effects.In the use of prone position combined with PPV,the common factors affecting ventilation or oxygenation should be given extra an attention,such as the changes in respiratory mechanics,intra-abdominal pressure(IAP)and hemodynamics.However,consensus is lacking on optimal proning protocols and patient selection criteria.The causes of acute hypoxia and respiratory failure are complex,and should be assessed accurately.The success rate of rescuing critically ill patients can be improved by applying multiple effective treatments and standardized implementing prone position and PPV to improve oxygenation at the same time.

关 键 词：俯卧位 保护性肺通气 平均系统充盈压 临界闭合压 腹内压 

分 类 号：R459.7[医药卫生—急诊医学]