tailieunhanh - Báo cáo khoa học: "Treatment of atelectasis: where is the evidence"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Treatment of atelectasis: where is the evidence? | Available online http content 9 4 341 Commentary Treatment of atelectasis where is the evidence Margrid B Schindler Consultant in Paediatric Intensive Care Paediatric Intensive Care Unit Bristol Royal Hospital for Children Bristol UK Corresponding author Margrid B Schindler Published online 7 July 2005 Critical Care 2005 9 341-342 DOI cc3766 This article is online at http content 9 4 341 2005 BioMed Central Ltd See related research by Hendriks et al. in this issue http content 9 4 R351 Abstract Lobar atelectasis is a common problem caused by a variety of mechanisms including resorption atelectasis due to airway obstruction passive atelectasis from hypoventilation compressive atelectsis from abdominal distension and adhesive atelectasis due to increased surface tension. However evidence-based studies on the management of lobar atelectasis are lacking. Examination of airbronchograms on a chest radiograph may be helpful to determine whether proximal or distal airway obstruction is involved. Chest physiotherapy nebulised DNase and possibly fibreoptic bronchoscopy might be helpful in patients with mucous plugging of the airways. In passive and adhesive atelectasis positive end-expiratory pressure might be a useful adjunct to treatment. In this issue of Critical Care Hendriks and colleagues 1 report on the use of nebulised or endotracheal DNase in paediatric patients with atelectasis. Pulmonary atelectasis is one of the most common abnormalities encountered on chest radiography and is caused by a variety of processes. These include resorption atelectasis caused by resorption of alveolar air distal to obstructing lesions of the airways adhesive atelectasis from increased surface tension and surfactant deficiency after ventilator-associated pneumonia passive atelectasis caused by diaphragmatic dysfunction or hypoventilation compressive atelectasis due to spaceoccupying intrathoracic lesions or