Acute respiratory distress syndrome: is the concept of protective ventilation and driving pressure the real future?
Journal
Macedonian Journal of Anesthesia
Date Issued
2019-10
Author(s)
Vlajkovic A
Stevic M
Budic I
Marjanovic V
Ducic S
Simic D
Abstract
Since the original description of acute respiratory distress syndrome was made 50 years ago,
much has been learned regarding the pathology and pathophysiology of the clinical syndrome.
However, no pharmacologic treatments aimed at the underlying pathology have been shown to
be effective, and management remains supportive with lung-protective mechanical ventilation.
Controlled mechanical ventilation of patients with acute respiratory distress syndrome (ARDS)
may contribute to morbidity and mortality by causing ventilator-induced lung injury (VILI). As
well mechanical ventilation is critical for survival for many ARDS patients, numerous efforts
over the past 50 years have been directed towards minimizing lung injury during mechanical
ventilation.
Lung-protective ventilation strategy suggests the use of low tidal volume, depending on ideal
body weight, limited plateau pressure, and adequate levels of PEEP. We can’t always prevent
overstress and overstrain by reducing tidal volume according to ideal body weight. On the con-
trary, titrating mechanical ventilation on airway driving pressure, should better reflect lung injury.
much has been learned regarding the pathology and pathophysiology of the clinical syndrome.
However, no pharmacologic treatments aimed at the underlying pathology have been shown to
be effective, and management remains supportive with lung-protective mechanical ventilation.
Controlled mechanical ventilation of patients with acute respiratory distress syndrome (ARDS)
may contribute to morbidity and mortality by causing ventilator-induced lung injury (VILI). As
well mechanical ventilation is critical for survival for many ARDS patients, numerous efforts
over the past 50 years have been directed towards minimizing lung injury during mechanical
ventilation.
Lung-protective ventilation strategy suggests the use of low tidal volume, depending on ideal
body weight, limited plateau pressure, and adequate levels of PEEP. We can’t always prevent
overstress and overstrain by reducing tidal volume according to ideal body weight. On the con-
trary, titrating mechanical ventilation on airway driving pressure, should better reflect lung injury.
File(s)![Thumbnail Image]()
Loading...
Name
anes br 7 finalna.pdf
Size
2.62 MB
Format
Adobe PDF
Checksum
(MD5):7bf90e3fa1816f8f4ffdeb7fdade4123