Implicazioni respiratorie nella sepsi - Dott. Lorenzo Mirabile
Implicazioni respiratorie nella sepsi - Dott. Lorenzo Mirabile
Implicazioni respiratorie nella sepsi - Dott. Lorenzo Mirabile
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
!<br />
<br />
"<br />
<br />
# $ %
Murray JF, Matthay MA, e coll<br />
An expanded definition of respiratory distres<br />
Syndrome. Am Rev Resp Dis 1988; 138: 720,725
' ( ' )*+ + ,<br />
- ) . "<br />
) <br />
"<br />
/ ++ 012,303.34102215+ 34102215+ 46,447.<br />
4840221<br />
<br />
<br />
<br />
<br />
<br />
+- 9$ 4:%$ 4+); .
) 9"% "<br />
+0227540,060.067<br />
<br />
,<br />
+ , &<br />
<br />
+ , <br />
<br />
+ , ) <br />
# & # @
! " #$%<br />
& &'%(#) *<br />
+,) -$) → <br />
. /<br />
0 ! " 1+2$%)<br />
) ( * )9 A <<br />
B C,)< <br />
)B ) < "<br />
/ " "+"+0DE,0881.08164668
% , <br />
<br />
% , <br />
<br />
%
! 3<br />
3 <br />
&
) <br />
' < 9"% )/ < F ) < 466D
' < 9"% )/ < F ) < 466D
G <br />
% <br />
H B .( 9 9 I"<br />
$ ,<br />
G <br />
,<br />
9+= 9 H04.03> IJ <br />
9 9 ,<br />
0I H I<br />
4I H- I<br />
8I <br />
1I$ <br />
H9 I
G <br />
.4 -<br />
5 2(<br />
6 7 /<br />
3 /<br />
<br />
" 5 /<br />
&& (<br />
( <br />
8 3 .- <br />
9- 6( :: -
; .4 <br />
• % <br />
<br />
%
G - +<br />
, ). ). )"<br />
$ , H9- ; .<br />
: . G . KI<br />
)- +# ( <br />
,<br />
+ → <br />
→ <br />
→ # L <br />
9
- +9 <br />
L' @ +$ M → - +,<br />
) M<br />
M<br />
.<br />
9N ( @ ' G N - O N $<br />
H I<br />
( 9 99 "9 ) - +<br />
- +→ 99. 9<br />
- <br />
9 9→<br />
. G <br />
. P G - <br />
P G - "<br />
<br />
9 9 9"<br />
9Q "<br />
9 9Q <br />
( 9 9 9 9 - G <br />
/ ++ "02275070,036E.0301
F 9R 99→ - +<br />
• < : : : :
+% → 0:8 <br />
→ ' ' S N @ ( M<br />
9:G <br />
<br />
"<br />
+ & <br />
→ "<br />
% <br />
999<br />
= @ ,
0 <br />
<br />
<br />
3<br />
5<br />
<br />
'<br />
*<br />
/
. → <br />
<br />
# L "<br />
+ ,<br />
0I ) C<br />
4IC <br />
8I LH"9"<br />
J9 9I<br />
$ ,<br />
G <br />
9+= 9# <br />
L G "L→<br />
B .( 9 "
-<br />
, <br />
<br />
L<br />
, <br />
99 , <br />
H@ $ I
$ @ <br />
G <br />
<br />
<br />
<br />
<br />
G :O "<br />
,7.46<br />
99<br />
<br />
@ $
@ $ ,<br />
<br />
><br />
! <br />
/! .<br />
@<br />
+) 3 <br />
&A <br />
<br />
<br />
'> *-<br />
B
B <br />
&→<br />
C <br />
'2&<br />
*& '*
&<br />
3 -<br />
*D%(#+)<br />
&*↑ ' C &<br />
6 * -<br />
E*↑ : : -F .→ <br />
(<br />
/<br />
* 2<br />
↑ ↓ : : <br />
↑ /<br />
0 -↓ @<br />
* .
- G <br />
<br />
<br />
<br />
<br />
<br />
<br />
- G 9 9↑ <br />
<br />
→ + <br />
→ <br />
<br />
G <br />
<br />
<br />
<br />
% <br />
H <br />
I H <br />
) I <br />
<br />
G - 99 <br />
! ! (" G (7 (&H <br />
&I<br />
0@EJJ$KEL-EJ2E$E
9:G H " I<br />
G "- " 1.3:CHD7.37> <br />
I<br />
9 T86> 4$ H # ) <br />
LI<br />
99 06.07> 4$ U9L. <br />
<br />
%" " 46.D6' L+$ 4<br />
: 0:40:0 99↓ +$<br />
%$ 4 TD6R 36P 9$ 416.D6> $ 4<br />
<br />
> %$ G<br />
• P 30-50 cmH2O in funzione di PaCO2 e rendere visibile<br />
oscillazione<br />
• MAP 15-30 cm H2O per il reclutamento polmonare<br />
• Oscillaz. 3-10 Hz per diminuireo aumentare il VT<br />
• I/E ratio 1:3 1:1 meglio 1:1 nelle forme didiffuse lung injuri<br />
• FiO2
" <br />
<br />
, 94J<br />
<br />
% <br />
+ <br />
)
! .<br />
'! :@ *<br />
+ L +$ 4<br />
. <br />
H7.07:CI"<br />
<br />
( +$ 4<br />
H↓46> I<br />
L <br />
<br />
& H06P +$ I"
! :@<br />
@ 4662 <br />
<br />
"
+ \ 9<br />
2(& <br />
@- <br />
@ .+) <br />
@(/<br />
0<br />
<br />
' <br />
5 &22*/<br />
(<br />
3( <br />
<br />
/
+ $<br />
" <br />
> -<br />
E*0'01<br />
..E%%> *<br />
F$%<br />
*E%%) → " DL%)<br />
* >DE%%<br />
$* <br />
(<br />
+*A <br />
#*" <br />
,*: (
M+: @<br />
<br />
" NE%%@<br />
<br />
@ <br />
'$:@OP *
9 )<br />
<br />
<br />
) <br />
) <br />
<br />
) + $ <br />
,<br />
C
@:@<br />
EJL+2%%$