Many aspects of ventilatory management in patients with ARDS are still controversial and one of the major controversies is should HFO or CMV ideally be used to manage this patients. As shown by David et al. when the two approaches to ventilatory support are applied using similar principles the physiologic outcomes appear to be similar. With both approaches the use of lung recruitment maneuvers early in ARDS (1 to 3 day) after hemodynamic stabilization in patients without baratrauma is promising. The key to managing ARDS regardless of mode is to use an open lung protective ventilatory strategy. It is not the mode that makes the difference, it is the approach used to apply the mode!

译文

:ARDS患者的通气管理的许多方面仍存在争议,主要争议之一是是否应理想地使用HFO或CMV来管理该患者。如David等所示。当使用相似的原理应用两种通气支持方法时,其生理结果似乎相似。对于这两种方法,在无原发性出血的患者中,在血液动力学稳定后的ARDS早期(1至3天)使用肺募集手术是有希望的。无论采用哪种模式,管理ARDS的关键都是采用开放式肺保护性通气策略。造成差异的不是模式,而是应用模式的方法!

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