Resumo

GUERRERO TOPETE, Hugo Eduardo et al. Patient Self-Inflicted Lung Injury (P-SILI) in the Intensive Care Unit. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.4, pp.240-248.  Epub 02-Dez-2022. ISSN 2448-8909.  https://doi.org/10.35366/105796.

To date, the superiority of any particular mode of invasive mechanical ventilation has not been demonstrated; most authors emphasize the individualization of the programming and modality of mechanical ventilation, taking into account the presence of asynchronies and seeking the best patient comfort; even spontaneous ventilation, although it seems to resemble the physiological manner of respiratory mechanics, is not free of complications. Three potential mechanisms are proposed for the development of lung injury by spontaneous respiratory effort: global and local overdistension, increased pulmonary perfusion and the presence of patient-ventilator asynchronies, resulting in a Patient Self-Inflicted Injury or «P-SILI». In the last twenty years, strategies have been developed to minimize the risks associated with mechanical ventilation, the most important of which is to maintain goal-directed ventilatory support, identify the possible development of the patient and extubate the patient as quickly as possible, as long as the patient’s conditions allow it.

Palavras-chave : Spontaneous breathing; respiratory drive; P-SILI; acute respiratory distress syndrome.

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