TAILIEUCHUNG - Báo cáo y học: " ICU Cornerstone: High frequency ventilation is here to stay"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: ICU Cornerstone: High frequency ventilation is here to stay. | Critical Care October 2003 Vol 7 No 5 Rimensberger Commentary ICU Cornerstone High frequency ventilation is here to stay Peter C Rimensberger Clinical Director Pediatric and Neonatal ICU Department of Pediatrics University Hospital of Geneva Geneva Switzerland Correspondence Peter C Rimensberger Published online 2 July 2003 Critical Care 2003 7 342-344 DOI cc2327 This article is online at http content 7 5 342 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract With favourable and extensive experience in the neonatal intensive care unit ICU and the recent positive experience in the adult ICU high-frequency ventilation has become a valuable alternative to conventional ventilation in acute lung injury. To arrive at this point physicians understanding of the characteristics and kinetics of acute lung injury had to become more distinct and it was necessary to merge accumulated knowledge from experience with high-frequency ventilation in the neonatal population and that with conventional ventilation in adults. However this now calls for a better designed clinical trial in the adult population that combines the three most important concepts for lung protection early intervention before acute respiratory distress syndrome is established optimal lung recruitment and careful avoidance of lung over-distention over the entire period of mechanical ventilation. Keywords acute lung injury respiratory distress syndrome adult high-frequency ventilation hypercapnia respiratory distress syndrome infant respiratory physiology As medical students we were told that mechanical ventilation needs convective gas flow. As residents we learned then that we must normalize gas exchange during mechanical ventilation. We also learned based on the Radford nomogram published in 1954 1 that there are some normal respiratory rates and some normal tidal volumes that may be employed to mimic normal physiology. However as Henderson

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