Chinese Society of Critical Care Medicine-CSCCM 10th Anniversary

讲座摘要

机械通气进展 Update in mechanical ventilation

Jean-Damien Ricard

Introductory words

I am very please and honoured to be here with you in Shangai and I would like to thank the organizing committee for having invited me.

It’s the first I have the opportunity to be in China, and I must say I’m really thrilled with what I’ve seen so far.

I was asked to make an update on mechanical ventilation.

I have therefore selected a number of studies published in 2009 dealing with different aspects of mechanical ventilation; going right from the start with intubation, to the end of it, extubation.

Abstract

First slides: intubation

the study is a randomized controlled study, that compared rapid sequence intubation either with etomidate or with ketamine.

The primary outcome measure was the maximum value of the SOFA score over the first three days of mechanical ventilation.

Results indicate that patient intubated with etomidate had a similar outcome to those intubated with ketamine.

Second set of slides: new modes of ventilation

These slides will comment upon several studies that have evaluated new modes of ventilation:

ASV = adaptive support ventilation, PSV = pressure support ventilation

NAVA = neurally adjusted ventilatory assist, APV = adapted pressure ventilation.

Third set of slides will cover: studies dealing with the treatment of the acute respiratory distress syndrome (ARDS)

ECMO (ExtraCorporal Membrane Oxygenation) will be discussed, along with prone position, use of neuromuscular blocking agents (NMBA)

The fourth set of slides will cover the area of muscles and nerves

Two studies will be commented:

one on the effect of early physical and occupational therapy in mechanically ventilated critically ill patient,

the second on the impact of the presence and intensity of Intensive Care Unit-acquired paresis.

The last set of slides will discuss the use of NIV to treat post-extubation respiratory failure

第二届中法危重病医学研讨会暨上海重症医学论坛（2009年12月中国上海）