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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: Ventilator strategies to reduce lung injury – lessons from pediatric and neonatal intensive care. | Available online http ccforum.eom content 9 2 177 Review Bench-to-bedside review Ventilator strategies to reduce lung injury - lessons from pediatric and neonatal intensive care Sally H Vitali1 and John H Arnold2 Assistant Department of Anesthesia and Critical Care Medicine Children s Hospital Boston and Instructor in Anaesthesia Harvard Medical School Boston Massachusetts USA 2Senior Associate Department of Anesthesia and Critical Care Medicine Children s Hospital Boston and Associate Professor of Anaesthesia Pediatrics Harvard Medical School Boston Massachusetts USA Corresponding author John H Arnold john.arnold@childrens.harvard.edu Published online 4 November 2004 This article is online at http ccforum.com content 9 2 177 2004 BioMed Central Ltd Critical Care 2005 9 177-183 DOI 10.1186 cc2987 Abstract As in the adult with acute lung injury and acute respiratory distress syndrome the use of lung-protective ventilation has improved outcomes for neonatal lung diseases. Animal models of neonatal respiratory distress syndrome and congenital diaphragmatic hernia have provided evidence that gentle ventilation with low tidal volumes and open-lung strategies of using positive end-expiratory pressure or high-frequency oscillatory ventilation result in less lung injury than do the traditional modes of mechanical ventilation with high inflating pressures and volumes. Although findings of retrospective studies in infants with respiratory distress syndrome congenital diaphragmatic hernia and persistent pulmonary hypertension of the newborn have been similar to those of the animal studies prospective randomized controlled trials have yielded conflicting results. Successful clinical trial design in these infants and in children with acute lung injury acute respiratory distress syndrome will require an appreciation of the data supporting the modern ventilator management strategies for infants with lung disease. Introduction Although the first animal studies demonstrating the .
