Development of a new mechanical ventilation method to minimize lung injury in acute respiratory failure

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K08815
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Osaka University
• Principal Investigator: Uchiyama Akinori 大阪大学, 大学院医学系研究科, 准教授 (00324856)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: Mechanical ventilation / Respiratory failure / Lung injury / Endotracheal cuff / Dead space / COVID19

Outline of Final Research Achievements

Mechanical ventilation is essential in the treatment of acute respiratory failure, but it also has the potential to cause lung injury, which can worsen the prognosis. This is known as ventilator-associated lung injury, and prevention of its occurrence is crucial. Lung-protective ventilation strategies, such as limiting tidal volume and airway pressure, and appropriate positive end-expiratory pressure settings, are important. However, since there are limitations to conventional lung-protective ventilation, we investigated a ventilation strategy that can significantly reduce dead space by controlling the cuff pressure of the endotracheal tube and improve the ventilation setting, using a model lung. In addition, we retrospectively examined factors that may affect the prognosis during early-stage lung-protective ventilation, which combined muscle relaxant administration and prone positioning in critically ill COVID-19 patients.

Free Research Field

Intensive Care Medicine

Academic Significance and Societal Importance of the Research Achievements

急性呼吸不全における人工呼吸法による肺傷害の問題点を指摘し、新たな肺保護換気法を提案した点が社会的に重要である。新型コロナウイルス感染症の流行など、呼吸器系の疾患が注目を集めているおり、この研究の成果は新しい治療法として発展する可能性がある。急性呼吸不全による人工呼吸の合併症を最小限に抑えることは、この研究はその解決に向けた一歩となる成果である。また、新型コロナウイルス感染症による重症呼吸器疾患に対する肺保護換気法の有効性について、後方視的な検討を行った点が社会的に重要である。この研究の結果が、現在の医療現場において、重症呼吸器疾患患者の治療に役立つことが期待される。