Anest. intenziv. Med. 2022;33(6):290-295 | DOI: 10.36290/aim.2022.036

Year 2022 in review - Respiratory failure and lung support therapyReview Article

Máca J.^1-3, Sklienka P.^1-3

¹ Klinika anesteziologie, resuscitace a intenzívní medicíny, Fakultní nemocnice Ostrava

² Katedra intenzívní medicíny, urgentní medicíny a forenzních oborů, Lékařská fakulta, Ostravská univerzita

³ Ústav fyziologie a patofyziologie, Lékařská fakulta, Ostravská univerzita

The use of ECMO methods has experienced a significant boom in recent years, mainly due to the SARS-CoV-2 pandemic. Many workplaces that had little or no experience with ECMO currently possess the relevant technology and can use this method in real clinical practice. The prone position (PP) has changed from the original position of rescue intervention to the leading position among the methods that should be considered standard in patients with a severe form of acute respiratory failure. Thus, the combination of pronation and ECMO support has received considerable attention in recent years. This text, although a year in the 2022 review, briefly discusses available evidence-based medicine publications over the past few years devoted to this topic. The use of PP in clinical conditions other than mechanical ventilation (MV), e.g. in conscious patients on non-invasive ventilatory support, is described in the next section of this text. Another topic is the correct setting of MV while using PP and the effect of PP in pregnant patients with COVID-19. Inhalational anesthetics and their use for sedation of patients on UPV are currently among the frequently discussed topics within the optimization of intensive care. Conversely, ventilator-induced dysfunction of the main respiratory muscles, especially the diaphragm, has been a serious topic in critical care for a long time. Next, critically ill patients are at risk of hyperoxemia both as part of MV and ECMO support. The negative impact of this condition is the final topic of the article.

Keywords: extracorporeal membrane oxygenation, prone position, analgosedation, inhalational anesthetics, ventilator­‑induced diaphragm dysfunction, hyperoxemia.

Received: November 7, 2022; Revised: November 7, 2022; Accepted: November 16, 2022; Published: December 21, 2022  Show citation