机械通风
重症监护医学
急性呼吸窘迫
通风(建筑)
医学
临床实习
呼吸窘迫
肺
物理疗法
内科学
外科
机械工程
工程类
作者
Filip Burša,David Oczka,Ondřej Jor,Peter Sklienka,Michal Frelich,J Stigler,Vojtěch Vodička,Tereza Ekrtová,Marek Penhaker,Jan Máca
出处
期刊:Medical Science Monitor
[International Scientific Information, Inc.]
日期:2023-07-31
卷期号:29
被引量:4
摘要
Mechanical ventilation (MV) provides basic organ support for patients who have acute hypoxemic respiratory failure, with acute respiratory distress syndrome as the most severe form. The use of excessive ventilation forces can exacerbate the lung condition and lead to ventilator-induced lung injury (VILI); mechanical energy (ME) or power can characterize such forces applied during MV. The ME metric combines all MV parameters affecting the respiratory system (ie, lungs, chest, and airways) into a single value. Besides evaluating the overall ME, this parameter can be also related to patient-specific characteristics, such as lung compliance or patient weight, which can further improve the value of ME for characterizing the aggressiveness of lung ventilation. High ME is associated with poor outcomes and could be used as a prognostic parameter and indicator of the risk of VILI. ME is rarely determined in everyday practice because the calculations are complicated and based on multiple equations. Although low ME does not conclusively prevent the possibility of VILI (eg, due to the lung inhomogeneity and preexisting damage), individualization of MV settings considering ME appears to improve outcomes. This article aims to review the roles of bedside assessment of mechanical power, its relevance in mechanical ventilation, and its associations with treatment outcomes. In addition, we discuss methods for ME determination, aiming to propose the most suitable method for bedside application of the ME concept in everyday practice.
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