机械通气与RM（参考）.pptVIP

A. Hypoxamia B. Shear forces C. Surfactants inactivate D. Biotrauma and MODS Pathophysiology Consolidation and alv collapse A .低氧血症 肺泡塌陷：ARDS重力依赖区 炎症或不张区 生理性低氧缩血管反应：障碍 How Does Excessive Mechanical Stress Inflame the Lung? “Shear” Verbrugge et al. Crit Care Med 1999;27：779 Ventilator-associated lung injury Purine: a marker of ATP breakdown and VILI 42 SD rats PCV 6min PCV Pre/PEEP BALF purine and protein Surfactant move away When lung regions collapse at end –expiration, surfactant molecules move away from the alv surface toward terminal bronchioles and