CAJ | 학술논문

背景高频振荡通气(high frequency oscillatory ventilation,HFOV)理论上符合肺保护通气策略,越来越多地应用于常规机械通气(conventional mechanical ventilation,CMV)下仍有低氧血症的急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者. 目的研究表明HFOV可以有效地改善低氧血症,但肺保护作用利用欠佳,文章旨在阐述如何更好地发挥HFOV的肺保护作用并同时满足氧合和安全性要求. 内容总结以往HFOV应用于ARDS患者的研究,并讨论HFOV临床应用的相关问题. 趋向基于大规模前瞻性随机对照研究结果,建议HFOV目前应作为常规肺保护性通气失败的补救措施.在使用HFOV前,要慎重考虑深度镇静肌松、血流动力学变化和噪音等对患者病情的影响.
배경 고빈진탕통기(high frequency oscillatory ventilation,HFOV)이론상부합폐보호통기책략,월래월다지응용우상규궤계통기(conventional mechanical ventilation,CMV)하잉유저양혈증적급성호흡군박종합정(acute respiratory distress syndrome,ARDS)환자. 목적 연구표명HFOV가이유효지개선저양혈증,단폐보호작용이용흠가,문장지재천술여하경호지발휘HFOV적폐보호작용병동시만족양합화안전성요구. 내용 총결이왕HFOV응용우ARDS환자적연구,병토론HFOV림상응용적상관문제. 추향 기우대규모전첨성수궤대조연구결과,건의HFOV목전응작위상규폐보호성통기실패적보구조시.재사용HFOV전,요신중고필심도진정기송、혈류동역학변화화조음등대환자병정적영향.
Background High-frequency oscillatory ventilation(HFOV) is an ideal lung-protective ventilation mode,which is more and more often used in adults with the acute respiratory distress syndrome (ARDS) remaining hypoxemic during conventional mechanical ventilation (CMV).Objective Though HFOV can improve oxygenation,the role of lung-protection doesn't play good.The aim of this paper is to reach consensus on an approach to HFOV that we thought would maximize its lung protective virtues while maintaining acceptable gas exchange and safety.Content In this review,we summarize the studies of HFOV and discuss the clinical experience using HFOV in adults in ARDS.Trend On the grounds of the results of more larger RCTs,HFOV should be reserved for patients failing conventional ventilation-based lung protective strategies.Before initiating HFOV,we should consider the consequences of heavy sedation and paralysis,hemodynamic changes and excessive noise.