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Papers of the Week


2020 Nov 25


Zhonghua Wei Chang Wai Ke Za Zhi


23


11

[Management strategy of lung protection in patients with intra-abdominal infection].

Authors

Liu YQ
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Nov 25; 23(11):1032-1035.
PMID: 33212550.

Abstract

Lung protection is important in the treatment of patients with intra-abdominal infection (IAI). This article focuses on the management strategy of lung protection in IAI patients. In the implementation of IAI individual respiratory protection, good humidification and chest physical therapy, nutritional support, strict balloon management, keeping a semi-supine position, and reducing the duration and depth of analgesia and sedation are helpful to maintain effective coughing capacity and prevent silent aspiration. It is also necessary to prevent ventilator-associated lung injury in mechanical ventilation, and implement strategies of small tidal volume, limited platform pressure, diaphragmatic protection and right heart protection ventilation in acute respiratory distress syndrome (ARDS). Respiratory mechanical indicators, including airway resistance, respiratory compliance, maximum inspiratory pressure (MIP), and airway closure pressure (P0.1) can be used in IAI patients receiving mechanical ventilation for individualized assessment and monitoring of respiratory functional status. Patients with IAI who have not been treated with mechanical ventilation can use simplified bedside lung function indicators, including forced vital capacity of inhalation and exhalation, maximum inspiratory pressure and exhalation pressure, as well as volume and rate of 1s. In pulmonary rehabilitation, the protection technique of the seven-word principle of humidification, turning, patting, coughing, expansion, blowing and mobilization are implemented.