Science review Mechanisms of ventilator-induced injury 英文参考文献.docVIP

Available online /content/7/3/233 Review Science review: Mechanisms of ventilator-induced injury James A Frank1 and Michael A Matthay2 1Assistent Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, Cardiovascular Research Institute, San Francisco, California, USA 2Professor of Medicine, Division of Pulmonary and Critical Care Medicine and the Department of Anesthesia, University of California, San Francisco, Cardiovascular Research Institute, San Francisco, California, USA Correspondence: James A Frank, frankja@ Published online: 16 October 2002 Critical Care 2003, 7:233-241 (DOI 10.1186/cc1829) This article is online at /content/7/3/233 ? 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Acute respiratory distress syndrome (ARDS) and acute lung injury are among the most frequent reasons for intensive care unit admission, accounting for approximately one-third of admissions. Mortality from ARDS has been estimated as high as 70% in some studies. Until recently, however, no targeted therapy had been found to improve patient outcome, including mortality. With the completion of the National Institutes of Health-sponsored Acute Respiratory Distress Syndrome Network low tidal volume study, clinicians now have convincing evidence that ventilation with tidal volumes lower than those conventionally used in this patient population reduces the relative risk of mortality by 21%. These data confirm the long-held suspicion that the role of mechanical ventilation for acute hypoxemic respiratory failure is more than supportive, in that mechanical ventilation can also actively contribute to lung injury. The mechanisms of the protective effects of low tidal volume ventilation in conjunction with positive end expiratory pressure are incompletely understood and are the focus of ongoing studies. The objective of the present article is to revie