小儿体外循环心脏手术中呼吸管理策略

Ventilation strategies in pediatric on-pump congenital heart surgeries

背景术后急性肺损伤是小儿体外循（cardiopulmonarybypass，CPB）心脏手术后主要并发症之一，是小儿心脏手术后死亡的主要原因之一。目的CPB后肺损伤可导致患儿术后恢复时间延长，增加术后并发症，CPB期间及CPB后期可采用一定肺保护性通气策略从而改善术后呼吸功能。内容目前关于CPB心脏手术中肺损伤机制及肺保护性通气策略的研究很广泛，但针对小儿先天性心脏病的研究相对缺乏，且具有局限性。趋向为减轻肺损伤、改善小儿先天性心脏病手术预后，小儿CPB心脏手术中呼吸管理策略有广阔的研究前景。

Background Postbypass acute lung injury in patients undergoing on-pump pediatric congenital heart surgery is associated with cardiopulmonary bypass, which is a major complication and cause of mortality. Objective Postbypass lung injury can lead to prolonged recovery time, and increase morbidity. Some lung protective ventilation strategies can be applied during and after bypass. It may improve postbypass respiratory function. Content The mechanisms of lung injury during cardiopulmonary bypass and lung protective ventilation strategies are widely studied in adult. But it is relatively scant in children and infants. Trend In order to decrease lung injury and improve prognosis after operation, lung protective ventilation strategies during and after cardiopulmonary should be further studied.