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Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) ›› 2021, Vol. 07 ›› Issue (01): 66-70. doi: 10.3877/cma.j.issn.2096-1537.2021.01.011

Special Issue:

• Review • Previous Articles     Next Articles

Pathogenesis and Interventions of patient self-inflicted lung injury in ARDS

Han Li1, Qiang Chen1, Xudong Han1,()   

  1. 1. Department of Critical Care Medicine, Nantong Third Hospital Affiliated to Nantong University, Nantong 226000, China
  • Received:2020-04-29 Online:2021-02-28 Published:2021-04-23
  • Contact: Xudong Han

Abstract:

Spontaneous breathing may offer multiple physiologic benefits for patients with ARDS, including decreased need for sedation, preserved diaphragm activity and improving cardiovascular function. However, vigorous spontaneous breathing efforts may aggravate lung injury. The effort-dependent lung injury has been termed 'patient self-inflicted lung injury (P-SILI)' in 2017. How to prevent P-SILI in ARDS and keep 'safe' spontaneous breathing become the research focus in clinical treatment. This article reviews the physiological and clinical significance of respiratory driving force in ARDS patients with self-inflicted lung injury, and discusses methods to evaluate respiratory driving force and measures to improve P-SILI, in order to provide theoretical basis for reducing lung injury in ARDS patients, and provide a new idea for the treatment of the latest outbreak of COVID-19.

Key words: Acute respiratory distress syndrome, Spontaneous breathing, Self-inflicted lung injury, Respiratory drive

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