Title: Recruitment Maneuvers
题目:肺泡复张手法
Author 作者: Michael Winters
Patients with ARDS who are ventilated with lung protective settings are at risk of derecruitment/collapse of lung units.
接受肺保护性机械通气的ARDS患者具有发生肺不张的危险。
Recruitment maneuvers are processes that transiently increase transpulmonary pressure to open collapsed units.
肺泡复张手法可以瞬时增加肺压,使不张的肺单位张开。
These maneuvers can improve oxygenation and have been used in patients with ARDS and those with refractory hypoxemia.
这些方法可以改善氧合,已用于ARDS患者和那些顽固性低氧血症患者。
The various types of recruitment methods include:
肺复张方法包括:
Airway pressure-based maneuver: a continuous positive airway pressure of 35-45 cm H2O is applied for 30-40 seconds
升高气道压力手法:持续正压(35-45 cmH2O)通气30-40秒。
Ventilator modes: Airway pressure release ventilation (APRV) and high-frequency oscillatory ventilation (HFOV)
呼吸机模式:气道压力释放通气(APRV)和高频振荡通气(HFOV
Prone positioning
俯卧位
Adverse events can occur with recruitment maneuvers and include hypotension, hypoxia, and pneumothorax (rare).
肺泡复张手法可出现不良反应,包括低血压,缺氧,和气胸(罕见)。
References 参考文献
Keenan JC, et al. Lung recruitment in acute respiratory distress syndrome: what is the best strategy? Curr Opin Crit Care 2014; 20:63-8.