Высокочастотная вентиляция легких в лечении острой дыхательной недостаточности
- Авторы: Перепелица С.А.1,2, Кузовлев А.Н.2
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Учреждения:
- Федеральное государственное автономное образовательное учреждение высшего образования «Балтийский федеральный университет имени Иммануила Канта»
- Федеральное государственное бюджетное научное учреждение «Федеральный научно-клинический центр реаниматологии и реабилитологии»
- Выпуск: Том 3, № 1 (2021)
- Страницы: 63-73
- Раздел: НАУЧНЫЙ ОБЗОР
- URL: https://journals.rcsi.science/2658-6843/article/view/63248
- DOI: https://doi.org/10.36425/rehab63248
- ID: 63248
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Аннотация
Потребность в респираторной терапии при острой дыхательной недостаточности может достигать 90% в зависимости от категории отделения реанимации и интенсивной терапии. В настоящее время имеется широкий выбор методов респираторной терапии, включая полностью управляемую вентиляцию легких, а также вспомогательные методы. Широкое применение искусственной вентиляции легких и ее разновидностей позволило значительно снизить летальность пациентов в отделении реанимации и интенсивной терапии. Однако смертность новорожденных с дыхательными расстройствами и пациентов с острым респираторным дистресс-синдромом и нозокомиальными пневмониями остается по-прежнему высокой. Высокочастотная искусственная вентиляция легких (ИВЛ) является альтернативным методом лечения тяжелой дыхательной недостаточности, тем не менее в практической деятельности применяется редко. Разработаны три основных вида высокочастотной ИВЛ — с положительным давлением (high-frequency positive pressure ventilation, HFPPV), струйная (high-frequency jet ventilation, HFJV) и осцилляторная (high-frequency oscillatory ventilation, HFOV), благодаря чему врач имеет возможность выбрать определенный режим, который наиболее подходит для конкретного пациента. Применение метода HFOV позволяет успешно проводить лечение новорожденных с тяжелой острой дыхательной недостаточностью, обусловленной первичным дефицитом сурфактанта, мекониальной аспирацией, полиорганной недостаточностью. В последние годы появились публикации о возможности проведения неинвазивной высокочастотной ИВЛ как у взрослых пациентов, так и в детской практике. В статье рассматриваются и обсуждаются возможности высокочастотной ИВЛ в лечении дыхательной недостаточности.
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Светлана Александровна Перепелица
Федеральное государственное автономное образовательное учреждение высшего образования «Балтийский федеральный университет имени Иммануила Канта»; Федеральное государственное бюджетное научное учреждение «Федеральный научно-клинический центр реаниматологии и реабилитологии»
Автор, ответственный за переписку.
Email: sveta_perepeliza@mail.ru
ORCID iD: 0000-0002-4535-9805
д.м.н., профессор, ведущий науч. сотр.
Россия, Калининград; МоскваАртём Николаевич Кузовлев
Федеральное государственное бюджетное научное учреждение «Федеральный научно-клинический центр реаниматологии и реабилитологии»
Email: artem_kuzovlev@mail.ru
ORCID iD: 0000-0002-5930-0118
д.м.н., доцент
Россия, МоскваСписок литературы
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