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Regional Monitoring

Most respiratory monitors consider the whole lung to behave similarly. Imaging was and for a long time the only available way to describe the structural (but not the functional) lung heterogeneity. Lung diseases when heterogenous (eg, ARDS, atelectasis, and lobar consolidation) creates a state of regional mechanical heterogeneity.7It follows that applying unified MV settings across heterogenous regions to result in variable and sometimes unpredictable effects ranging from atelectasis, recruitment to overdistention, risking worsening gas exchange 6 Journal of Intensive Care Medicine 0(0) and VILI. If this regional heterogeneity can be identified and fed back to the clinician, an individualized management can pursue.

区域监测

大多数呼吸监测仪只能把肺当做同质的整体来监测。长期以来，影像是描述异质性肺结构（而非功能性）的唯一方法。当肺部疾病（例如，ARDS、肺不张和肺叶实变）出现异质的肺结构，就会产生局部的力学异质状态。因此，在异质区域应用统一的MV设置，会导致可变且有时不可预测的影响，从肺不张、肺复张到肺过度膨胀、气体交换恶化风险和VILI等。如果可以识别这种区域异质性并反馈给临床医生，就可以追求个体化的管理。