Progress in optimization of lung protective ventilation strategy in patients with acute respiratory distress syndrome
Lei Hui
Song Shengren
Zhang Xianming
Abstract：Acute respiratory distress syndrome(ARDS)poses a severe challenge to the treatment of mechanical ventilation due to its complex pathophysiological characteristics.Optimization of lung protective ventilation strategy is considered to be the key to reduce the incidence of ventilation-induced lung injury and improve the prognosis of patients.However,due to the regional heterogeneity of lung lesions in ARDS patients,a single ventilation parameter setting is difficult to meet individual needs.In recent years,monitoring techniques based on respiratory mechanics,such as respiratory electromyography and esophageal manometry,have made it possible to accurately regulate personalized ventilation parameters.Respiratory electromyography can quantify diaphragm activity and respiratory muscle fatigue in real time,so as to optimize ventilator synchrony.By assessing the transpulmonary pressure gradient,esophageal manometry can guide the reasonable setting of positive end-expiratory pressure and tidal volume to reduce the risk of alveolar overdistension and repeated opening.The combination of these technologies can not only significantly reduce the incidence of ventilation-induced lung injury in patients with ARDS,but also improve oxygenation level and lung compliance.This article systematically reviews the research progress of lung protective ventilation strategy optimization in ARDS patients based on respiratory mechanics,focusing on the application advantages and future development direction of respiratory electromyography and pressure monitoring technology in individualized treatment.
Keywords：Acute respiratory distress syndromeRespiratory mechanicsLung protective ventilation strategyRespiratory electromyographyEsophageal pressure monitoring
Publication Date：2025-09-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 1420-1425 )