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Mechanical ventilation of patients with acute lung injury.
Sessler, C N.
Afiliación
  • Sessler CN; Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA. csessler@gems.vcu.edu
Crit Care Clin ; 14(4): 707-29, vii, 1998 Oct.
Article en En | MEDLINE | ID: mdl-9891634
Ventilatory management of patients with acute lung injury (ALI), particularly its most severe subset, acute respiratory distress syndrome (ARDS), is complex. Newer lung protective strategies emphasize measures to enhance alveolar recruitment and avoid alveolar overdistention, thus minimizing the risk of ventilator-induced lung injury (VILI). Key components of such strategies include the use of smaller-than-conventional tidal volumes which maintain peak transpulmonary pressure below the pressure associated with overdistention, and titration of positive end-expiratory pressure to promote maximal alveolar recruitment. Novel techniques, including prone positioning, inverse ratio ventilation, tracheal gas insufflation, and high frequency ventilation, are considerations in severe ARDS. No single approach is best for all patients; adjustment of ventilatory parameters to individual characteristics, such as lung mechanics and gas exchange, is required.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Síndrome de Dificultad Respiratoria Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Crit Care Clin Asunto de la revista: TERAPIA INTENSIVA Año: 1998 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Síndrome de Dificultad Respiratoria Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Crit Care Clin Asunto de la revista: TERAPIA INTENSIVA Año: 1998 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos