有创呼吸支持技术的进展与挑战

Advances and challenges in invasive respiratory support technique

有创呼吸支持技术作为挽救危重症患者生命的重要生命支持手段之一,临床上通过动态观察反映肺应力的驱动压和跨肺压指标,评价肺的应变。并应用新的监测手段,如重症超声、电阻抗等,建立个体化动态评价有创呼吸支持的临床解决方案,指导肺保护性通气、呼气末正压(PEEP)滴定、肺复张、俯卧位通气、体外膜肺氧合等呼吸支持技术,在有效改善危重症患者有效氧合的同时尽量减少有创通气的副作用。

Invasive respiratory support technique is one of the important life support methods to save the life of critical patients.Clinically,dynamic observation is used to reflect the driving pressure and transpulmonary pressure indexes of pulmonary stress,and to evaluate pulmonary strain.New monitoring methods,such as critical ultrasound and electrical impedance tomography(EIT),are used to establish individualized dynamic evaluation of the clinical solution of invasive respiratory support,to guide respiratory support techniques such as lung protective ventilation,positive end-expiratory pressure(PEEP)titration,lung recruitment,prone position ventilation and extra-corporeal membrane oxygenation,so as to effectively improve the effective oxygenation of critical patients and minimize the side effects of invasive ventilation.