机械功率在呼吸机相关性肺损伤的研究现状

Research status of mechanical power in ventilator-induced lung injury

早期关于呼吸机相关性肺损伤(VILI)的研究主要集中在通气的"静态"特征,如潮气量、平台压、呼气末正压和驱动压等.但机械通气的"动态"特性也不容忽视,如呼吸频率和流速等.目前综合考虑多种因素的机械能及机械功率(描述机械能的工作速率)逐渐引起大家的关注.呼吸机产生的机械能主要用于扩张呼吸系统和克服阻力,一部分能量直接作用在肺组织,从而产生热量和炎症,导致肺损伤.本文主要介绍了机械能和机械功率的相关概念及其与VILI之间的关系,以期有助于进一步理解VILI的相关因素.

The ventilator-induced lung injury(VILI)was centered on the"static"characteristics of the mechanical ventilation in early phases(tidal volume,plateau pressure,positive end-expiratory pressure and driving pressure).But the"dynamic"characteristics of ventilation must not be ignored(respiratory rate and flow).Mechanical energy and mechanical power(the pace of performing energy load)regarding all factor have won wide spread attention.The energy generated by mechanical ventilation is mainly used to expand respiratory system and overcome resistance,a fraction of energy acts on lung tissues probably inducing"heat"and inflammation that is related to lung injury.The review described recent conceptual advances regarding the mechanical energy and power,and the relationship with VILI,hoping to help further understanding the risk factors for VILI.