Clinical study on evaluation of pulmonary recruitment with different body position and positive end-expiratory pressure mode in stage of mechanical ventilation in severe acute respiratory distress syndrome
10.3760/cma.j.issn.1673-4904.2017.06.006
- VernacularTitle:重度急性呼吸窘迫综合征早期联合不同体位和呼气末正压模式对机械通气评价肺可复张性的临床研究
- Author:
Kaiyuan HE
;
Zhenji LUO
;
Zhaohui WANG
;
Dongmei LI
;
Lixiu WU
- Keywords:
Respiratory distress syndrome,adult;
Prone position;
Positive- pressure respiration
- From:
Chinese Journal of Postgraduates of Medicine
2017;40(6):504-508
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of pulmonary recruitment (RM) in severe acute respiratory distress syndrome (ARDS) with different body position and positive end-expiratory pressure (PEEP) mode in stage of mechanical ventilation. Methods From June 2013 to June 2016, 80 cases of ICU hospitalized patients with clinical data were enrolled, and they lay in the prone or supine position (prone position group and supine position group, each of 40 cases). The hemodynamic parameters including heart rate (HR), central venous pressure (CVP) and peripheral arterial pressure, respiratory mechanics index including respiratory rate (RR), respiratory system compliance (Crs) and platform pressure (Pplate), and the changes of blood gas analysis index were monitored to observe the effects of RM in different positions with positive end expiratory pressure increasing method. Results The levels of oxygenation index and arterial partial pressure of oxygen (PaO2) were improved 3, 5 and 7 d after treatment compared with those 1 d after treatment (P<0.05), and they were improved significantly in prone position group than those in supine position group 3 and 5 d after treatment (P<0.05). The levels of RR, Crs and Pplate 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had significant differences compared with those before RM (P<0.01). The levels of HR, CVP, peripheral arterial pressure 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had no significant differences compared with those before RM (P>0.05). Conclusions For patients with severe ARDS, early implementation of prone position ventilation combined with PEEP increasing method re-expansion treatment is safe and reliable. It can effectively improve oxygenation level and help to improve the survival rate.
