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Báo cáo y học: " Low tidal volume, high respiratory rate and auto-PEEP: the importance of the basic"

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: Low tidal volume, high respiratory rate and auto-PEEP: the importance of the basics. | Available online http ccforum.eom content 7 2 105 Commentary Low tidal volume high respiratory rate and auto-PEEP the importance of the basics Nicolò Patroniti1 and Antonio Pesenti2 1 Medical Doctor Research Fellow Institute of Anesthesia and Intensive Care Unit Department of Surgical Science and Intensive Care Milano-Bicocca University Milan Italy 2Medical Doctor Professor of Anesthesia and Intensive Care Institute of Anesthesia and Intensive Care Unit Department of Surgical Science and Intensive Care Milano-Bicocca University Milan Italy Correspondence Antonio Pesenti antonio.pesenti@unimib.it Published online 31 January 2002 Critical Care 2003 7 105-106 DOI 10.1186 cc1883 This article is online at http ccforum.com content 7 2 105 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Recent studies have shown that application of the ARDSNet low tidal volume strategy i.e. allowing an increase in respiratory rate in order to minimize hypercapnia in those with low tidal volume may generate consistent auto-PEEP positive end-expiratory pressure and this is not efficient in improving clearance of carbon dioxide. The present commentary deals with some of the recent controversies related to use of a low tidal volume strategy as implemented in the ARDSNet trial which has proved successful in reducing mortality rates in patients with acute respiratory distress syndrome. We emphasize the importance of basic physiological knowledge and sound respiratory monitoring. Keywords acute respiratory distress syndrome auto-PEEP high respiratory rate hypercapnia low-tidal volume strategy . the wisdom of old men. They do not grow wise. They grow careful. A Farewell to Arms Ernest Hemingway The ARDSNet trial 1 which compared a low versus a high tidal volume Vt ventilation strategy appears to have said the final word in the controversy surrounding the clinical relevance of ventilator-induced lung injury. That study indeed showed that patients with acute respiratory