Đang chuẩn bị liên kết để tải về tài liệu:
Báo cáo y học: "Mechanisms of ventilator-induced lung injury: the clinician’s perspective"

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: Mechanisms of ventilator-induced lung injury: the clinician’s perspective. | Available online http ccforum.eom content 7 3 209 Commentary Mechanisms of ventilator-induced lung injury the clinician s perspective Gaetane Michaud1 and Pierre Cardinal2 Critical Care Fellow University of Ottawa Ontario Canada 2Program Director Critical Care Medicine University of Ottawa Ontario Canada Correspondence Gaetane Michaud gaet@netcom.ca Published online 24 January 2003 Critical Care 2003 7 209-210 DOI 10.1186 cc1874 This article is online at http ccforum.com content 7 3 209 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract In the present issue of Critical Care Frank and Matthay review the physiologic mechanisms that lead to ventilator-induced lung injury. Our greater understanding of basic physiologic principles has already had a major impact on the treatment of critically ill patients. Novel strategies to limit ventilator-induced lung injury have now been shown to improve survival. However there has been debate in the literature regarding the safety and efficacy of the Acute Respiratory Distress Syndrome ARDS Network study protocol in reducing ventilator-induced lung injury. The issues surrounding the ARDS Network protocol and a recent meta-analysis criticizing its use are presented. As clinicians we now have the responsibility to ensure that our patients benefit from these recent developments. Keywords acute respiratory distress syndrome ARDS Network lung injury lung protective strategy mechanical ventilation Management of patients with adult respiratory distress syndrome ARDS has been a therapeutic challenge for years. Despite scientific interest there has been a lack of high quality clinical studies demonstrating a mortality benefit. In 2000 a large trial funded by the US National Institutes of Health NIH 1 demonstrated a 9 reduction in absolute mortality in patients ventilated with a low tidal volume strategy 6 ml kg versus 12 ml kg . This clinical finding is supported by many animal experiments that have also shown that