Ten golden rules for individualized mechanical ventilation in acute respiratory distress syndrome
| Autor: | Patricia R. M. Rocco, Lorenzo Ball, Chiara Robba, Paolo Pelosi, Denise Battaglini, Marco Sottano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
ARDS
medicine.medical_treatment RM recruitment maneuver RR relative risk PEEP positive end-expiratory pressure VT tidal volume Critical Care and Intensive Care Medicine Protective mechanical ventilation Plateau pressure FiO2 fraction of inspired oxygen PaO2 partial pressure of oxygen Acute respiratory distress syndrome (ARDS) Respiratory system Crs respiratory system compliance RCT randomized controlled trial Tidal volume MV mechanical ventilation Medical emergencies. Critical care. Intensive care. First aid respiratory system Extracorporeal membrane oxygenation (ECMO) ICU intensive care unit Respiratory dialysis Extracorporeal CO2 Removal (ECCO2R) ECCO2R extracorporeal CO2 removal Prone position Cardiology medicine.medical_specialty Respiratory rate ΔP driving pressure VILI ventilator-induced lung injury Lung injury Article Extracorporeal CO2 removal (ECCO2R) Internal medicine medicine Acute Respiratory Distress Syndrome(ARDS) iNO inhaled nitric oxide PaCO2 partial pressure of carbon dioxide ARDS acute respiratory distress syndrome Mechanical ventilation SBT spontaneous breathing trial business.industry RC86-88.9 NIV non-invasive ventilation medicine.disease MP mechanical power respiratory tract diseases CI confidence interval NMBA neuromuscular blocking agent PSV pressure-support ventilation business ECMO extracorporeal membrane oxygenation PBW predicted body weight Pplat plateau pressure |
| Zdroj: | Journal of Intensive Medicine, Vol 1, Iss 1, Pp 42-51 (2021) Journal of Intensive Medicine |
| Popis: | Over the last decades, great strides have been made in the management of acute respiratory distress syndrome (ARDS). Mechanical ventilation remains the cornerstone of supportive therapy for ARDS. Lung-protective mechanical ventilation minimizes the risk of ventilator-induced lung injury (VILI) and improves survival. Several parameters are determinants of VILI and require careful setting, such as tidal volume (VT), plateau pressure (Pplat), driving pressure (DP), positive end-expiratory pressure (PEEP), and respiratory rate. Furthermore, measurement of energy and mechanical power may enable quantification of the relative contribution of its different components (VT, Pplat, ΔP, PEEP, respiratory rate, and airflow) and better individualize mechanical ventilation settings. The use of neuromuscular blocking agents is of interest, mainly in cases of severe ARDS, to improve oxygenation and reduce asynchrony; however, no significant changes in survival have been observed. Rescue respiratory therapies, such as prone positioning, inhaled nitric oxide, and extracorporeal support techniques may also be used in specific situations. Furthermore, respiratory weaning protocols should be discussed. After reviewing all recent clinical trials, we now present 10 golden rules to individualize mechanical ventilation in ARDS management. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|