Accurate evaluation of mechanical ventilation and spontaneous respiratory activity
10.3760/cma.j.cn121430-20220119-00080
- VernacularTitle:准确评估机械通气与自主呼吸活动
- Author:
Yingzhi QIN
1
Author Information
1. 天津市第三中心医院重症医学科，天津 300170
- Keywords:
Spontaneous breath;
Ventilator-induced lung injury;
Pendelluft phenomenon;
Effort-dependent lung injury;
Transpulmonary pressure
- From:
Chinese Critical Care Medicine
2022;34(4):343-345
- CountryChina
- Language:Chinese
-
Abstract:
Maintenance of spontaneous effort during mechanical ventilation has long been recognized to improve oxygenation. Such effort has been considered beneficial because oxygenation is a key management aim. However, accumulating evidence indicates that spontaneous effort during mechanical ventilation may cause or worsen acute lung injury. Recently, effort-dependent lung injury has been termed as patient-self inflicted lung injury (P-SILI). This paper describes pathophysiological changes of ventilation-induced lung injury (VILI) induced by mechanical ventilation and spontaneous breathing, and the role of spontaneous breathing during mechanical ventilation in acute respiratory distress syndrome (ARDS). Studies have shown that spontaneous breathing is a double-edged sword, depending on the intensity of spontaneous breathing activity and the severity of lung injury. Future studies are needed to determine ventilator strategies minimizing injury.
