[The basics on mechanical ventilation support in acute respiratory distress syndrome]. / Fundamentos de la ventilación mecánica en el síndrome de distrés respiratorio agudo.
Med Intensiva
; 34(6): 418-27, 2010.
Article
em Es
| MEDLINE
| ID: mdl-20097448
Acute Respiratory Distress Syndrome (ARDS) is understood as an inflammation-induced disruption of the alveolar endothelial-epithelial barrier that results in increased permeability and surfactant dysfunction followed by alveolar flooding and collapse. ARDS management relies on mechanical ventilation. The current challenge is to determine the optimal ventilatory strategies that minimize ventilator-induced lung injury (VILI) while providing a reasonable gas exchange. The data support that a tidal volume between 6-8 ml/kg of predicted body weight providing a plateau pressure < 30 cmH2O should be used. High positive end expiratory pressure (PEEP) has not reduced mortality, nevertheless secondary endpoints are improved. The rationale used for high PEEP argues that it prevents cyclic opening and closing of airspaces, probably the major culprit of development of VILI. Chest computed tomography has contributed to our understanding of anatomic-functional distribution patterns in ARDS. Electric impedance tomography is a technique that is radiation-free, but still under development, that allows dynamic monitoring of ventilation distribution at bedside.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Síndrome do Desconforto Respiratório
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Es
Revista:
Med Intensiva
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Espanha