Key issues of lung protective ventilation strategies and diaphragm protection
10.11855/j.issn.0577-7402.2542.2023.0920
- VernacularTitle:肺保护性通气策略及膈肌保护的关键问题
- Author:
Ting YE
1
;
Hua-Ping XIAO
Author Information
1. 南昌大学医学院麻醉系,江西南昌 330006
- Keywords:
general anesthesia;
mechanical ventilation;
pulmonary complications;
lung-protective;
diaphragm-protective
- From:
Medical Journal of Chinese People's Liberation Army
2023;48(11):1276-1286
- CountryChina
- Language:Chinese
-
Abstract:
With the continuous development and progress of medicine,the total number of general anesthetic surgery is increasing,and postoperative complications are also on the rise,especially postoperative pulmonary complications(PPCs)caused by perioperative lung injury.PPCs are the main cause of prolonged hospitalization,increased morbidity and mortality,poor prognosis,and increased medical burden in patients undergoing general anesthesia.With the enhancement of awareness of mechanical ventilation and the implementation of the enhanced recovery after surgery(ERAS)concept,lung-protective ventilation strategies(LPVS)are receiving more and more attention.However,the debate continues on how to apply the LPVS effectively.The recent introduction of diaphragm-protective ventilation as a novel concept has led to the realization that the application of protective ventilation strategies should limit the adverse effects of mechanical ventilation on diaphragm function within the context of lung protective ventilation.How to apply protective ventilation strategies effectively to prevent the development of ventilator-induced lung injury(VILI)and ventilator-induced diaphragm dysfunction(VIDD),reduce the incidence of PPCs,improve patient prognosis,and reduce the medical burden is an important challenge in the management of mechanically ventilated patients.In this paper,we will focus on ventilation strategies of lung and diaphragm combined with the latest progress of LPVS,to elaborate the research on the application of individualized ventilation strategies and the mechanisms of VILI and VIDD occurrence.Finally,prospecting the future research direction of protective ventilation strategies.
