高频喷射通气对重度烧伤合并吸入性损伤患者早期的呼吸支持

目的　观察高频喷射通气 (highfrequencyjetventilation ,HFJV)对重度烧伤合并吸入性损伤患者早期的治疗作用。　方法　 2 0例重度烧伤 (TBSA 79.6 %± 2 9.3% )并吸入性损伤患者 ,其中 19例行气管切开手术 ,1例经鼻插管。为防低氧血症 ,所有患者均应用HFJV ,观察通气前和通气后 11d内血气、呼吸率和脉搏等指标的变化。　结果　气管切开时间为伤后 (2 .7± 2 .4 )d ,HFJV时间为伤后(4.4 0± 2 .9)d。HFJV后 1～ 3d ,PaO2 显著高于通气前水平 (P <0 .0 1) ,随后HFJV 1周 ,PaO2 仍维持在较高水平。在整个通气期间 ,PaCO2 、呼吸率和脉搏率均无明显变化。结论　在重度烧伤合并吸入性损伤早期 ,HFJV有利于氧合作用的改善而无明显副作用 ,是一较为适用的呼吸支持方式

Respiratory support with high freguency jet ventilation in severely burned patients with inhalation injury during early postburn stage

OBJECTIVE: To observe the effects of respiratory support with high frequency jet ventilation (HFJV) in severely burned patients with inhalation injury during early postburn stage. METHODS: Twenty severely burned patients with TBSA of 79.6 +/- 29.3% and inhalation injury were enrolled in the study. Nineteen cases received tracheostomy after admission and only one received nasal intubation. All the patients underwent HFJV to correct hypoxia. The changes in blood gas analysis, respiratory rate and pulse were recorded before and 11 days after the ventilation. RESULTS: Tracheostomy was performed on 2.7 +/- 2.4 postburn days (PBDs), and HFJV was given during 4.4 +/- 2.9 PBDs. PaO(2) was evidently higher during 1 - 3 days after HFJV than that before the ventilation (P < 0.01) and remained at high level for 1 week after HFJV. There was no change in PaCO(2), respiratory rate and pulse during the ventilation. CONCLUSION: HFJV was beneficial in improving oxygenation and without any obvious side effects during the early management of severely burned patients with inhalation injury. This might be an optimal respiratory support pattern.