Implementation of individualized lung protective ventilation strategy for pediatrics acute respiratory distress syndrome guided by electrical impedance tomography and critical care ultrasound
10.3760/cma.j.issn.1673-4912.2021.09.001
- VernacularTitle:经胸电阻抗成像和重症超声导向的儿童急性呼吸窘迫综合征个体化肺保护通气策略实施
- Author:
Long XIANG
1
;
Qiushi YANG
;
Ying WANG
;
Fang ZHANG
;
Teng TENG
;
Juanzhen LI
;
Xiaomei ZHONG
;
Hong REN
;
Biru LI
;
Jian ZHANG
Author Information
1. 上海交通大学医学院附属上海儿童医学中心重症医学科 200127
- Keywords:
Pediatrics;
Acute respiratory distress syndrome;
Lung protective ventilation
- From:
Chinese Pediatric Emergency Medicine
2021;28(9):745-750
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the implementation of individualized lung protection ventilation strategy in pediatric acute respiratory distress syndrome(pARDS)guided by transthoracic electrical impedance tomography(EIT)and critical care ultrasound(CCU).Methods:We retrospectively analyzed the therapeutic process of protective ventilation strategy in one case of severe pARDS.EIT and CCU were used to guide the implementation of lung protective ventilation strategy.Results:EIT was used to guide lung recruitment and optimal positive end-expiratory pressure titration.CCU was used to assess hemodynamics and lung status of ARDS patient, and guide the implementation of right ventricular protective ventilation and circulatory protective ventilation.Finally, the patient eventually survived.Conclusion:The idea of ARDS protective ventilation has changed from traditional lung protective ventilation to right heart protective ventilation and circulatory protective ventilation, and finally achieved the protection of pulmonary vascular endothelium.EIT and CCU enrich the understanding of the pathophysiology and protective ventilation strategy in pARDS.
