Пропорциональная вспомогательная вентиляция
https://doi.org/10.18705/2311-4495-2020-7-1-39-52
Аннотация
Идея пропорциональной вспомогательной вентиляции легких, при которой респираторный паттерн — частоту и глубину дыхания — задает сам пациент, была высказана в 1992 году, однако до сих не нашла широкого практического применения. Одной из возможных причин тому является сложный алгоритм настройки режима на респираторах первых поколений. Со временем накопленный массив информации о раннем поражении диафрагмы в результате ее атрофии у пациентов, находящихся на респираторной поддержке, лег в основу осознания важности поддержания физиологического состояния диафрагмы во время искусственной вентиляции легких и обусловил появление термина «миотравма». На рубеже XXI века идея максимально возможного сохранения самостоятельного дыхания у пациента во время проведения механической вентиляции легких реализовалась в формировании концепции «диафрагма-протективной вентиляции». Стала очевидной необходимость дальнейшего развития технологий вспомогательной вентиляции легких, призванных уменьшить риск повреждения диафрагмы, снизить частоту асинхронии в паре «пациент–респиратор», облегчить процесс отлучения пациента от аппарата искусственной вентиляции легких. Настоящая статья, основанная на данных литературы и собственном клиническом опыте использования пропорциональной вентиляции, описывает особенности настройки режима на разных респираторах, расставляет акценты, необходимые для успешного клинического использования пропорциональной вентиляции легких. Описывает условия ее проведения, преимущества и ограничения.
Об авторе
В. А. Мазурок
Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации
Россия
Россия
Мазурок Вадим Альбертович, д.м.н., профессор, заведующий кафедрой анестезиологии и реаниматологии Института медицинского образования
ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341
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Рецензия
Для цитирования:
Мазурок В.А. Пропорциональная вспомогательная вентиляция. Трансляционная медицина. 2020;7(1):39-52. https://doi.org/10.18705/2311-4495-2020-7-1-39-52
For citation:
Mazurok V.A. Proportional assist ventilation. Translational Medicine. 2020;7(1):39-52. (In Russ.) https://doi.org/10.18705/2311-4495-2020-7-1-39-52
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