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positive end expiratory pressure

重症

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词汇介绍

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解析

positive 英 [ ˈpɒzətɪv ] 美 [ ˈpɑ:zətɪv ]  

释义   adj. 积极的;[数] 正的,[医][化学] 阳性的;确定的,肯定的;实际的,真实的;绝对的 ;n. 正数;[摄] 正片

例句   So no matter what you do, be positive.

所以无论你做什么,都要积极。

 

expiratory 英 [ eks'paɪrət(ə)rɪ ] 美 [ ɛks'paɪərətəri ]   

释义   adj. [生理] 呼气的;吐气的

例句   In order to measure the changing expiratory flow correctly, the sensor must meet the undistorted measurement requirement within its working frequency range.

为了正确测量呼气流量的变化,传感器必须在其工作频率范围内满足不失真的测量要求。

 

Pressure 英 [ ˈpreʃə(r) ] 美 [ ˈpreʃər ]  

释义   n. 压力;压迫,[物] 压强 ;vt. 迫使;密封;使……增压

例句   He would not knuckle down under their pressure.

他不会屈服于他们的压力。


概述

患者出现呼吸衰竭时,可以发生严重的动态肺过度通气(DPH)和高水平的内生呼吸末正压(PEEPi),损害心功能,增加气压伤危险,降低吸气肌收缩效率和异常增加无效呼吸功能。机械通气时加用外源性PEEP,可对抗动态气道受压,以下游阻力平衡PEEPi的上游阻力,只要加用的PEEP水平小于PEEPi,就不会影响呼气流速和肺容量。PEEP可增加肺顺应性,减小呼吸肌作功,过高潮气量或高水平PEEP都可使肺泡过度扩张而形成肺大泡产生气胸的可能。所以临床应用时,尤其是对于可能合并肺气肿的患者而言,更应严格掌握

Positive-end expiratory pressure titration and transpulmonary pressure: the EPVENT 2 trial 复制标题

呼气末正压滴定和经肺压力: EPVENT 2试验

发表时间:2019-09-11

影响因子:2.0

作者: Turbil E

期刊:J Thorac Dis

The acute respiratory distress syndrome (ARDS) is an acute inflammatory lung edema. The current definition includes three severity stages based on PaO2/FiO2 ratio measured at positive end-expiratory pressure (PEEP) of 5 cmH2O or more. ARDS was described for the first time by Ashbaugh et al. in 1967; it was suggested that PEEP could have beneficial effects. More than 50 years after its initial description ARDS is still of great concern for the intensivist because it accounts for 10% of ICU admissions and still supports a rough 40% mortality rate . Furthermore, ARDS can only be treated in the ICU environment because it very often requires invasive mechanical ventilation and because the mechanical ventilation settings can impact patient outcome. Indeed, the use of low tidal volume (VT) is strongly recommended as it has been demonstrated to decrease absolute mortality by 9% in the landmark ARMA randomized control trial (RCT). It is worth mentioning that this trial was innovative in many aspects, like the titration of VT according predicted (PBW), not measured, body weight, the monitoring of plateau pressure (Pplat), the adjustment of respiratory rate up to 35 breaths/minute, and a pragmatic way to set PEEP.

译文

急性呼吸窘迫综合征(ARDS)是一种急性炎症性肺水肿。当前的定义包括三个严重程度阶段,这些阶段基于在5 cmH2O或更高的呼气末正压(PEEP)时测得的PaO2 / FiO2比。 Ashbaugh等人首次描述了ARDS。 1967年;有人认为PEEP可能有有益的作用。在最初描述之后的50多年里,ARDS仍然是强化治疗师的高度关注,因为它占ICU入院人数的10%,仍然支持大约40%的死亡率。此外,ARDS只能在ICU环境中进行治疗,因为它经常需要有创的机械通气并且机械通气设置会影响患者预后。确实,强烈建议使用低潮气量(VT),因为在具有里程碑意义的ARMA随机对照试验(RCT)中已证明可将绝对死亡率降低9%。值得一提的是,该试验在很多方面都是创新的,例如根据预测值(PBW)进行VT滴定(未测量),体重,监测高原压力(Pplat),最多35次呼吸/分钟的呼吸频率调整,以及一种实用的方式来设置PEEP。