肺保护性镇静:应重视呼吸驱动和吸气努力的床旁评估  

Lung protective sedation:emphasize bedside assessment of respiratory drive and inspiratory effort

作　　者：苗明月 周建新 Miao Mingyue;Zhou Jianxin(Clinical and Research Center on Acute Lung Injury,Emergency and Critical Care Medical Center,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院急危重症医学中心、急性肺损伤临床诊疗与研究中心,北京100038

出　　处：《中华重症医学电子杂志》2024年第4期325-328,共4页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：首都医科大学临床诊疗与研究中心项目(CMU-2023-45)

摘　　要：镇痛镇静是重症患者治疗的重要环节,其治疗目的已经从改善患者舒适度进展到器官功能保护。对于机械通气患者,新近提出的肺保护性镇静概念,是对优化机械通气、镇静策略和呼吸机相关肺-膈肌损伤三者内在关联的进一步认识。也提示临床医师对机械通气患者的镇痛镇静管理,应在唤醒量表评估的基础上,有针对性地对呼吸驱动和吸气努力进行评估和调控,以达到肺-膈肌保护性通气的目的。Analgesia and sedation play important roles in critically ill patients,with the target shifting from improving patient comfort to organ function protection.For mechanically ventilated patients,the newly proposed concept of lung-protective sedation represents a further understanding of the inherent interconnection between optimizing mechanical ventilation,sedation strategies,and respiratory-related lungdiaphragm injuries.It also reminds clinicians that in the analgesic and sedation management of mechanically ventilated patients,they should evaluate and regulate respiratory drive and inspiratory effort in a targeted manner based on the arousal scale assessments to achieve the purpose of lung-diaphragm protective ventilation.

关 键 词：镇静 机械通气 器官保护 监测 

分 类 号：R614[医药卫生—麻醉学]