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[The basics on mechanical ventilation support in acute respiratory distress syndrome]. / Fundamentos de la ventilación mecánica en el síndrome de distrés respiratorio agudo.
Tomicic, V; Fuentealba, A; Martínez, E; Graf, J; Batista Borges, J.
Afiliação
  • Tomicic V; Unidad de Cuidados Intensivos, Clínica Alemana de Santiago, Unidad de Paciente Crítico, Hospital Padre Hurtado, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile. vtomicic@gmail.com
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.
Assuntos

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

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