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 ngành y học đề tài: Bench-to-bedside review: Chest wall elastance in acute lung injury/acute respiratory distress syndrome patients. | Critical Care October 2004 Vol 8 No 5 Gattinoni et al. Review Bench-to-bedside review Chest wall elastance in acute lung injury acute respiratory distress syndrome patients Luciano Gattinoni Davide Chiumello Eleondra Carlesso and Franco Valenza Institute of Anesthesia and Critical Care University of Milan Policlinico - IRCCS Hospital Milan Italy Corresponding author Luciano Gattinoni gattinon@ Published online 7 May 2004 This article is online at http content 8Z5 350 2004 BioMed Central Ltd Critical Care 2004 8 350-355 DOI cc2854 Abstract The importance of chest wall elastance in characterizing acute lung injury acute respiratory distress syndrome patients and in setting mechanical ventilation is increasingly recognized. Nearly 30 of patients admitted to a general intensive care unit have an abnormal high intra-abdominal pressure due to ascites bowel edema ileus which leads to an increase in the chest wall elastance. At a given applied airway pressure the pleural pressure increases according to in the static condition the equation pleural pressure airway pressure X chest wall elastance total respiratory system elastance . Consequently for a given applied pressure the increase in pleural pressure implies a decrease in transpulmonary pressure airway pressure - pleural pressure which is the distending force of the lung implies a decrease of the strain and of ventilator-induced lung injury implies the need to use a higher airway pressure during the recruitment maneuvers to reach a sufficient transpulmonary opening pressure implies hemodynamic risk due to the reductions in venous return and heart size and implies a possible increase of lung edema partially due to the reduced edema clearance. It is always important in the most critically ill patients to assess the intra-abdominal pressure and the chest wall elastance. Keywords acute respiratory distress syndrome chest wall elastance intra-abdominal pressure pleural pressure .
