胸壁压迫在急性呼吸窘迫综合征通气中的应用前景

The application of chest wall compression in ventilation of acute respiratory distress syndrome patients

急性呼吸窘迫综合征(ARDS)是一种危及生命的非心源性肺水肿。尽管肺保护性通气策略是ARDS治疗的基石,但部分患者仍无法有效缓解低氧血症或减少呼吸机相关性肺损伤。近期研究发现,通过胸壁或腹部按压可以改善肺顺应性,缓解ARDS患者吸气末期肺泡过度膨胀。胸壁压迫作为一种对仰卧患者胸部腹侧施加重物的方法,具有潜在的临床获益能力,也被认为是诊断ARDS患者肺泡过度通气的方法之一。本综述从生理及临床角度分析胸壁压迫在ARDS患者通气中的应用,并探讨其机制与临床意义,旨在为ARDS患者的治疗提供新思路和依据。

Acute respiratory distress syndrome(ARDS)is a life-threatening non-cardiogenic pulmonary edema.Despite lung-protective ventilation strategies serving as the cornerstone of ARDS treatment,some patients still fail to effectively alleviate hypoxemia or reduce ventilator-induced lung injury.Recent studies have revealed that chest or abdominal compression can improve lung compliance and mitigate alveolar overdistension during the end-inspiratory phase in ARDS patients.Chest wall compression,as a method of applying weight to the ventral aspect of the chest in supine patients,holds potential clinical benefits and is recognized as one of the diagnostic tools for alveolar hyperventilation in ARDS patients.This review aims to analyze the application of chest wall compression in the ventilation of ARDS patients from both physiological and clinical perspectives,exploring its mechanisms and clinical significance.Ultimately,it seeks to provide novel insights and evidence for the treat-ment of ARDS patients.