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Ventilations à haute fréquence au cours du SDRA

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Le syndrome de détresse respiratoire aiguë

Part of the book series: Le point sur ... ((POINT))

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Abstrait

La ventilation mécanique conventionnelle (VMC) représente la pierre angulaire de la prise en charge thérapeutique des patients atteints du syndrome de détresse respiratoire aiguë (SDRA). Paradoxalement, la VMC peut aussi engendrer des lésions pulmonaires surajoutées. Ce phénomène, connu sous le terme de lésions induites par la ventilation mécanique, apparaît lorsque les alvéoles sont surdistendues par ľutilisation ďun volume courant (VT) trop élevé, à ľorigine ďune rupture de la barrière alvéolo-capillaire (1). Ces lésions pulmonaires sont également liées aux forces de cisaillement mécanique exercées par les phénomènes ďouverture-fermeture alvéolaires répétitifs. Ces lésions mécaniques stimulent la production de cytokines inflammatoires perpétuant un cercle vicieux ďagression et inhibant la réparation du tissu pulmonaire. En outre, la libération des médiateurs pulmonaires peut générer une réponse systémique à ľorigine ďun syndrome de défaillance multiviscérale (2). Ainsi, le but ďune ventilation protectrice pulmonaire n’est pas simplement ďaméliorer les échanges gazeux mais aussi ďatténuer la réponse inflammatoire pour améliorer la survie des patients en SDRA (3, 4).

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Authors and Affiliations

  1. Service de réanimation polyvalente, Hôpital Font Pré, 1205, avenue Colonel Picot, 83000, Toulon

    D. Demory

  2. Service de réanimation médicale, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274, Marseille Cedex 9

    J. Allardet-Servent

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  1. D. Demory
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  2. J. Allardet-Servent
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© 2008 Springer-Verlag France

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Demory, D., Allardet-Servent, J. (2008). Ventilations à haute fréquence au cours du SDRA. In: Le syndrome de détresse respiratoire aiguë. Le point sur .... Springer, Paris. https://doi.org/10.1007/978-2-287-77986-2_9

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  • DOI: https://doi.org/10.1007/978-2-287-77986-2_9

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-77985-5

  • Online ISBN: 978-2-287-77986-2

  • eBook Packages: MedicineMedicine (R0)

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