overdistension in ventilated childrenoverdistension通风的孩子.pdfVIP

Critical Care August 2001 Vol 5 No 4 Nève et al Review Overdistension in ventilated children Véronique Nève, Francis Leclerc, Eric Dumas de la Roque, Stéphane Leteurtre and Yvon Riou Service de Réanimation Pédiatrique, Centre Hospitalier et Universitaire de Lille, Lille, France Correspondence: Francis Leclerc, fleclerc@chru-lille.fr Published online: 13 July 2001 Critical Care 2001, 5:196–203 © 2001 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Ventilating patients with acute respiratory failure according to standardized recommendations can lead to varying volume–pressure (V-P) relationships and overdistension. Young children may be more susceptible than adults to overdistension, and individual evaluation of the effects of ventilator settings is therefore required. Three studies have applied indices for the detection of overdistension to dynamic V-P curves in ventilated children. Two of those studies compared these indices to those obtained using a reference technique ([quasi]-static V-P curves), and suggested that the c coefficient of a second order polynomial equation (SOPE) and the ratio of the volume-dependent elastance to total dynamic elastance (%E2) were suitable indices for estimating overdistension. Keywords constant flow insufflation, low flow inflation, overdistension, ventilated children, volume–pressure curve Analysis of respiratory V-P curves is increasingly being In patients with the acute respiratory distress syndrome included in the evaluation of whether ventilator settings (ARDS), the classical shape of the V-P curve is altered. are suited to the mechanical pro