Clinical observation of prone position ventilation combined with lung recruitment maneuver in the treatment of severe ARDS patients
10.3760/cma.j.issn.1008-6706.2019.09.016
- VernacularTitle: 俯卧位通气联合肺复张治疗重度急性呼吸窘迫综合征的临床疗效观察
- Author:
Xijiao YAN
1
;
Wenkai ZHANG
1
;
Linyi HOU
1
;
Shengbiao ZHANG
2
Author Information
1. Department of Critical Care Medicine, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
2. Department of Respiratory Diseases, Xishan Coal and Electricity General Staff Hospital, Shanxi Coking Coal Group, Taiyuan, Shanxi 030053, China
- Publication Type:Journal Article
- Keywords:
Respiratory distress syndrome, adult;
Respiration, artificial;
Prone position ventilation;
Lung recruitment;
Treatment
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(9):1088-1091
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of mechanical ventilation in prone position combined with lung recruitment on severe acute respiratory distress syndrome (ARDS).
Methods:From February 2015 to February 2017, 82 patients with ARDS admitted to ICU of the Second Hospital of Shanxi Medical University were divided into two groups according to random number table, with 41 cases in each group.The study group was treated with mechanical ventilation in prone position combined with lung recruitment therapy, and the control group was treated with mechanical ventilation in supine position combined with lung recruitment therapy.The differences of heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), plateau pressure (Pplat), and static pulmonary compliance (Cst) were compared between the two groups before treatment (T0), and 1h (T1), 2h (T2), 6h (T3) after treatment.
Results:The PaO2 and PaO2/FiO2 levels of the two groups increased significantly after lung recruitment.In the study group at different time after treatment, PaO2[(69.17±7.51)mmHg, (74.64±6.78)mmHg, (82.52±10.37)mmHg], PaO2/FiO2 [(116.91±15.57)mmHg, (123.06±16.34)mmHg, (135.23±18.41)mmHg]were higher than those in the control group[PaO2: (64.23±7.72)mmHg, (68.51±8.05)mmHg, (73.43±9.12)mmHg; PaO2/FiO2: (106.50±12.97)mmHg, (115.42±13.19)mmHg, (123.42±14.95)mmHg], the differences were statistically significant (t=3.225, 3.254, 4.245, 3.954, 3.886, 4.135, all P<0.05). HR and CVP increased at T2-T3, T3 decreased, MAP decreased at T2-T3, and T3 increased in both two groups.HR at T1-T3 in the study group were (123.17±13.41)times/min, (114.64±10.08)times/min, (102.52±6.57)times/min, which were lower than those in the control group[(129.23±12.75)times/min, (117.51±10.35)times/min, (108.43±9.77)times/min], the differences between the two groups were statistically significant (t=3.884, 4.215, 4.667, all P<0.05).
Conclusion:Prone position mechanical ventilation combined with lung recruitment can effectively improve the oxygenation status of severe ARDS, and has less effect on hemodynamics, and the effect is better than supine position mechanical ventilation combined with lung recruitment.
