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中华重症医学电子杂志 ›› 2019, Vol. 05 ›› Issue (04) : 307 -310. doi: 10.3877/cma.j.issn.2096-1537.2019.04.003

所属专题: 重症医学 文献

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机械能:评估呼吸机相关肺损伤的新思路
池熠1, 隆云1,(), 何怀武1   
  1. 1. 100730 北京,中国医学科学院 北京协和医学院 北京协和医院重症医学科
  • 收稿日期:2019-02-17 出版日期:2019-11-28
  • 通信作者: 隆云

Mechanical power: a novel idea on the assessment of ventilator-induced lung injury

Yi Chi1, Yun Long1,(), Huaiwu He1   

  1. 1. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2019-02-17 Published:2019-11-28
  • Corresponding author: Yun Long
  • About author:
    Corresponding author: Long Yun, Email:
引用本文:

池熠, 隆云, 何怀武. 机械能:评估呼吸机相关肺损伤的新思路[J]. 中华重症医学电子杂志, 2019, 05(04): 307-310.

Yi Chi, Yun Long, Huaiwu He. Mechanical power: a novel idea on the assessment of ventilator-induced lung injury[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(04): 307-310.

机械能是指呼吸机为实现肺通气而传递给呼吸系统的能量,能量大小可以通过P-V环的曲线下面积得到,也可以将能量表示为包含呼吸机参数和肺部特性的函数。近年来,有研究者认为机械能或许是一个从总体上评估呼吸机相关肺损伤的良好指标,进而用于指导最佳的机械通气策略。

Mechanical power of ventilation is defined as the energy delivered to respiratory system by ventilator. The value of power can be calculated by area under curve (AUC) of pressure-volume loop. Mechanical power can also be expressed as a function of ventilatory parameters and pulmonary characteristics. Recently, studies have suggested that mechanical power may be used as a good indicator to evaluate the ventilator-induced lung injury, which can further guide the optimal strategy of mechanical ventilation.

1
Protti A, Andreis DT, Milesi M, et al. Lung anatomy, energy load, and ventilator-induced lung injury [J]. Intensive Care Med Exp, 2015, 3(1): 34.
2
Gattinoni L, Tonetti T, Cressoni M, et al. Ventilator-related causes of lung injury: the mechanical power [J]. Intensive Care Med, 2016, 42(10): 1567-1575.
3
Cressoni M, Gotti M, Chiurazzi C, et al. Mechanical power and development of ventilator-induced lung injury [J]. Anesthesiology, 2016, 124(5): 1100-1108.
4
Serpa Neto A, Deliberato RO, Johnson AEW, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts [J]. Intensive Care Med, 2018, 44(11): 1914-1922.
5
Guerin C, Papazian L, Reignier J, et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials [J]. Crit Care, 2016, 20(1): 384.
6
Moraes L, Silva PL, Thompson A, et al. Impact of different tidal volume levels at low mechanical power on ventilator-induced lung injury in rats [J]. Front Physiol, 2018, 9: 318.
7
Santos RS, Maia LA, Oliveira MV, et al. Biologic impact of mechanical power at high and low tidal volumes in experimental mild acute respiratory distress syndrome [J]. Anesthesiology, 2018, 128(6): 1193-1206.
8
Protti A, Cressoni M, Santini A, et al. Lung stress and strain during mechanical ventilation [J]. Amer J Respir Crit Care Med, 2011, 183(10): 1354-1362.
9
Maia LA, Samary CS, Oliveira MV, et al. Impact of different ventilation strategies on driving pressure, mechanical power, and biological markers during open abdominal surgery in rats [J]. Anesth Analg, 2017, 125(4): 1364-1374.
10
Marini JJ, De Backer D, Ince C, et al. Seven unconfirmed ideas to improve future ICU practice [J]. Crit Care, 2017, 21(Suppl 3): 315.
11
Katira BH, Kuebler WM, Kavanagh BP. Inspiratory preload obliteration may injure lungs via cyclical "on-off" vascular flow [J]. Intensive Care Med, 2018, 44(9): 1521-1523.
12
Vasques F, Duscio E, Pasticci I, et al. Is the mechanical power the final word on ventilator-induced lung injury?—we are not sure [J]. Ann Transl Med, 2018, 6(19): 395.
13
Vasques F, Duscio E, Cipulli F, et al. Determinants and Prevention of Ventilator-Induced Lung Injury [J]. Crit Care Clin, 2018, 34(3): 343-356.
14
Mead J, Takishima T, Leith D. Stress distribution in lungs: a model of pulmonary elasticity [J]. J Appl Physiol, 1970, 28(5): 596-608.
15
Collino F, Rapetti F, Vasques F, et al. Positive End-expiratory Pressure and Mechanical Power [J]. Anesthesiology, 2019, 130(1): 119-130.
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