Clinical research progress of external chest-wall compression in acute respiratory distress syndrome

doi:10.3877/cma.j.issn.2096-1537.2024.03.006

Abstract

Abstract:

In managing novel coronavirus disease 2019 (COVID-19) associated acute respiratory distress syndrome (ARDS) patients, proper external chest-wall compression may be beneficial, making it a big challenge to rethink about traditional lung protective ventilation strategies. In recent years, many studies have shown that external chest-wall compression can improve oxygenation and respiratory mechanics in ARDS patients, but therapeutic result remains controversial. This article mainly reviews physiological effects, implementation methods and clinical applications of chest wall compression.

Key words: Acute respiratory distress syndrome, Mechanical ventilation, Respiratory mechanics, External chest-wall compression

Yunhui Ni, Yi Yang, Xueyan Yuan, Haibo Qiu. Clinical research progress of external chest-wall compression in acute respiratory distress syndrome[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(03): 243-247.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2024.03.006

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References 24

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作者及文献年份	加压方式与重量/压力	加压部位	加压时间	效果
Bottino等^[4]，2000	沙袋加压10 kg	前胸壁上部	-	顺应性改善
Samanta等^[3]，2014	水袋/配重加压4 kg（两侧各2 kg）	胸骨两侧（肋骨上方）	6 h	顺应性改善；氧合改善
Carteaux等^[5]，2021	水袋加压，水袋施加在胸壁的压力80 cmH₂O	前胸壁（胸骨上方）	-	顺应性改善；氧合改善
Kummer等^[6]，2021	手动加压	上腹部	5~6次呼吸	顺应性改善
Lassola等^[7]，2021	沙袋加压	胸壁（胸骨和肋骨上方）	-	顺应性改善；氧合改善
Rezoagli等^[8]，2021	Trendelenburg（–30°）；5 kg重物压迫胸壁；腹部压迫	体位；前胸壁；腹部	10 min/短暂	顺应性改善
Selickman等^[9]，2022	手动加压，至气道压力时间波形向上偏转≥2 cmH₂O	仰卧：剑突和耻骨之间的轴线垂直的患者脐上；俯卧：肋缘与髂骨之间的中点，垂直于腰椎	5次呼吸	顺应性改善
Bastia等^[10]，2022	水袋加压5kg（5 L-bag）	胸壁（胸骨和肋骨上方）	60 min	顺应性改善；氧合不改善
Umbrello等^[11]，2022	沙袋加压10 kg（两侧各5 kg），压力约35 cmH₂O	仰卧：胸壁（胸骨和肋骨上方）；俯卧：胸椎及肩胛骨上方	6 h	低顺应性患者顺应性改善；氧合改善

作者及文献年份	加压方式与重量/压力	加压部位	加压时间	效果
Bottino等^[4]，2000	沙袋加压10 kg	前胸壁上部	-	顺应性改善
Samanta等^[3]，2014	水袋/配重加压4 kg（两侧各2 kg）	胸骨两侧（肋骨上方）	6 h	顺应性改善；氧合改善
Carteaux等^[5]，2021	水袋加压，水袋施加在胸壁的压力80 cmH₂O	前胸壁（胸骨上方）	-	顺应性改善；氧合改善
Kummer等^[6]，2021	手动加压	上腹部	5~6次呼吸	顺应性改善
Lassola等^[7]，2021	沙袋加压	胸壁（胸骨和肋骨上方）	-	顺应性改善；氧合改善
Rezoagli等^[8]，2021	Trendelenburg（–30°）；5 kg重物压迫胸壁；腹部压迫	体位；前胸壁；腹部	10 min/短暂	顺应性改善
Selickman等^[9]，2022	手动加压，至气道压力时间波形向上偏转≥2 cmH₂O	仰卧：剑突和耻骨之间的轴线垂直的患者脐上；俯卧：肋缘与髂骨之间的中点，垂直于腰椎	5次呼吸	顺应性改善
Bastia等^[10]，2022	水袋加压5kg（5 L-bag）	胸壁（胸骨和肋骨上方）	60 min	顺应性改善；氧合不改善
Umbrello等^[11]，2022	沙袋加压10 kg（两侧各5 kg），压力约35 cmH₂O	仰卧：胸壁（胸骨和肋骨上方）；俯卧：胸椎及肩胛骨上方	6 h	低顺应性患者顺应性改善；氧合改善

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