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High-Frequency Ventilation for Acute Lung Injury and ARDS
Ist Teil von
Chest, 2000-09, Vol.118 (3), p.795-807
Ort / Verlag
Northbrook, IL: Elsevier Inc
Erscheinungsjahr
2000
Quelle
MEDLINE
Beschreibungen/Notizen
In patients with acute lung injury (ALI) and ARDS,conventional mechanical ventilation (CV) may cause additional lunginjury from overdistention of the lung during inspiration, repeatedopening and closing of small bronchioles and alveoli, or from excessivestress at the margins between aerated and atelectatic lung regions. Increasing evidence suggests that smaller tidal volumes(Vts) and higher end-expiratory lung volumes (EELVs) may beprotective from these forms of ventilator-associated lung injury and may improve outcomes from ALI/ARDS. High-frequency ventilation(HFV)-based ventilatory strategies offer two potential advantages over, CV for pateints with ALI/ARDS. First, HFV uses very small, Vts, allowing higher EELVs with less overdistention than ispossible with CV. Second, despite the small Vts, highrespiratory rates during HFV allow the maintenance of normal ornear-normal Paco2 levels. In this review, theuse of HFV as a lung protective strategy for patients with ALI/ARDS isdiscussed.