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Monitoring of the breathing effort Muneyuki TAKEUCHI 1 1Department of Intensive Care Medicine Osaka Women's and Children's Hospital pp.535-544
Published Date 2018/7/1
DOI https://doi.org/10.11477/mf.3102200534
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Spontaneous breathing improves the ventilation/perfusion relationship and promotes alveolar recruitment, but excessive inspiratory effort may exacerbate lung injury in patients with severe acute respiratory distress syndrome (ARDS) and worsen the prognosis. However, over-suppression of the inspiratory effort during mechanical ventilation may make liberation more difficult due to ventilator-induced diaphragmatic dysfunction. Therefore, accurate evaluation of the breathing effort is essential. The work of breathing and pressure-time product, which can be calculated by esophageal pressure, are gold standards for the evaluation of breathing effort. In current clinical settings, however, esophageal pressure is not commonly measured. Methods for estimating the effort of breathing in situations where esophageal pressure cannot be measured include P0.1, PAV+, the electrical activity of the diaphragm, and diaphragm ultrasound. In the future, proper evaluation and preservation of breathing effort may be common practice in the care of patients undergoing mechanical ventilation to restrict tidal volume and ΔP in patients with ARDS.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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