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Lesión pulmonar inducida por ventilación mecánica. En los últimos 30 Clinical risk factors of pulmonary barotrauma: a multivariate analysis. Am. J. Respir. ventilación mecánica mediante el aislamiento de la vía aérea por intubación o la posibilidad de rotura pulmonar por la presión positiva generada en la vía aérea. .. The incidence of ventilator induced pulmonary barotrauma in critically ill. Llámase ventilación pulmonar al intercambiu de gases ente los pulmones y l’ atmósfera. por que les investigaciones en relación a la ventilación mecánica siguieren y . el picu mengua los valores de PaC02 y nun aumentar el barotrauma.

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The evidence shows that direct mechanical injury is the main responsible of VILI and its remote ventilzcion amplification. The cyclic transpulmonary pressures that exceed lung inflation capacity can damage the epithelium-alveolar barrier, especially in association with insufficient PEEP to keep the mechanically unstable alveolar units open. At present time, therapies that can interfere and modulate efficiently the trigger of biological events leading to VILI have not been developed.

Thus, the only therapy available is the cautious use of mechanical ventilation MV. The wise implementation of MV strategy will result in a lower stress and strain of lung parenchyma, with reduction in its biological impact. Hence, the main message of this review is that the way we ventilate our patients is decisive in their outcome and we must try to minimize VILI from the moment we start to ventilate our patient.

In the present communication, we attempt to review basic concepts, anatomic-functional aspects of this mechanical phenomenon and its biological consequences. Clinical interventions that allow to attenuate the impact of ventilatory support are described. Volumen corriente o tidal. Volumen de reserva espiratorio. Numerosos otros condicionantes influyen en la susceptibilidad al desarrollo de DIVM.

Un ajuste adecuado de la PEEP es el pilar del concepto de ” open lung “. Si incrementamos la PEEP, podemos enfrentar dos situaciones: Son de mayor utilidad en la etapa aguda del SDRA. Podemos reconocer la siguiente secuencia en el desarrollo del DIVM: Hasta la fecha no se ha demostrado que el empleo de elevados niveles de PEEP sea mejor que el empleo de niveles moderados 42 ; los resultados dispares observados probablemente se deban a no limitar Pm en estrategias de alto PEEP.


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Ventilación mecánica. Efectos secundarios. Yatrogenia | Archivos de Bronconeumología

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