Effect of recruitment maneuver on acute respiratory distress syndrome
10.3760/cma.j.issn.1671-0282.2013.04.015
- VernacularTitle:肺复张对急性呼吸窘迫综合征的疗效观察
- Author:
Wenpeng YI
;
Xiao LI
;
Bing WEI
;
Chunsheng LI
- Publication Type:Journal Article
- Keywords:
Recruitment maneuver;
Acute respiratory distress syndrome;
Hemoduynamics;
Extravascular lung water index;
Inspiration pressure;
Positive end expiratory pressure;
Blood gas analysis;
Mechanical ventilation
- From:
Chinese Journal of Emergency Medicine
2013;22(4):409-413
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of recruitment maneuver (RM) on acute respiratory distress syndrome (ARDS).Methods A total of 7 patients with early ARDS were involved in this investigate with pressure-control ventilation of FiO2 =1.Hemodynamics and extravascular lung water index (EVLWI) were monitored.After airway preparation,the ventilation parameters were adjusted to inspiration pressure (Pi) =24 cm H2O,positive end-expiratory pressure (PEEP) =10 cm H2O,frequency (f) =50,inspiration/expiration (I/E) =5/1.Up regulated PEEP to 24 cm H2O and Pi to 45 cm H2O for 3 respiration cycles.Then down regulated Pi to 30 cm H2O and had the artery blood gas analysis immediately.If PaO2 ＜ 450 mm Hg,Pi was increased 5 cm H2O above the last one,until PaO2 ＞ 450 mm Hg,which was considered RM success.Then PEEP was decreased 2 cm H2O and repeated the cycle as formers until PaO2 ＜350 mm Hg.The optimal PEEP was 2cm H2O above that.Maintained this airway pressure at least for 4 hours.Artery blood gas and hemodynamics of pre-and post-RM were monitored.The RM would be stopped by any unstable hemodynamic.Results In 6 of 7 patients,PaO2 and PEEP were higher than the baseline (P ＜ 0.01) after 4 hours of RM ; EVLWI decreased (P ＜ 0.01).RM was stopped in 1 patient,because of the unstable hemodynamic.None of the 7 patients got RM complications ; meanwhile,6 patients were cured.Conclusions Applying RM on ARDS is safe and effective.
