Overview: The way of ventilating the ARDS lung deeply changed over the last 30 years, primarily due to a better understanding of physiological mechanisms involved in the mechanical ventilation, as heart and lung interaction and generation of ventilator induced lung injury. All this led to a "gentle lung ventilation" which, although proposed years before, became evident only after a large randomized trial. Understanding mechanisms is the basis of the medical reasoning. The lack of application of physiological sound approaches just "because evidence is lacking" may be of disadvantage for a single patient. We lost, as an example, 30 years of potential benefit of prone position, evident from a physiological perspective, just because "clinical evidence" was not available. Take home message Evidence is the final step of a long journey. Lack of evidence of promising and physiologically sound approach should not discourage the application in the single patient.

Physiology versus evidence based guidance for critical care practice / L. Gattinoni. ((Intervento presentato al convegno Future of Critical Care Medicine (FCCM) tenutosi a Laegenfeld nel 2014.

Physiology versus evidence based guidance for critical care practice

L. Gattinoni
2014

Abstract

Overview: The way of ventilating the ARDS lung deeply changed over the last 30 years, primarily due to a better understanding of physiological mechanisms involved in the mechanical ventilation, as heart and lung interaction and generation of ventilator induced lung injury. All this led to a "gentle lung ventilation" which, although proposed years before, became evident only after a large randomized trial. Understanding mechanisms is the basis of the medical reasoning. The lack of application of physiological sound approaches just "because evidence is lacking" may be of disadvantage for a single patient. We lost, as an example, 30 years of potential benefit of prone position, evident from a physiological perspective, just because "clinical evidence" was not available. Take home message Evidence is the final step of a long journey. Lack of evidence of promising and physiologically sound approach should not discourage the application in the single patient.
Settore MED/41 - Anestesiologia
Physiology versus evidence based guidance for critical care practice / L. Gattinoni. ((Intervento presentato al convegno Future of Critical Care Medicine (FCCM) tenutosi a Laegenfeld nel 2014.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/250067
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