ARDS患者机械通气时液体管理体会

目的：现就我科近四年收治的ARDS机械通气患者液体管理体会进行总结；方法：143例ARDS患者入院后均行气管插管呼吸机辅助通气，液体管理主要通过中心静脉压 (CVP) 及平均动脉压进行补液或利尿，随机将患者分为A组和B组，A组(n=98)采用了限制性液体复苏措施，B组(n=45)采用了常规液体复苏措施，对患者氧合指数、心率、血乳酸、尿量进行密切监测，对比分析两组临床疗效，并追踪其死亡率。结果：两组开始时指标相近，严格液体管理3天后A组氧合指数明显升高、心率减慢、血乳酸下降、尿量明显增加，具有显著性差异；A组病死率低于B组（P<0.05）。结论：机械通气ARDS患者根据CVP及平均动脉压进行限制性液体管理策略比非限制性液体管理更安全、有效，且能降低死亡率。

Fluid administration understanding of the acute respiratory distress syndrome (ARDS)patients receiving mechanical ventilation

Objectives：To summarize the fluid administration understanding of the acute respiratory distress syndrome (ARDS)patients receiving mechanical ventilation our ICU in this four years．Methods：143 ARDS patients receiving mechanical ventilation analyzed retrospectively who were randomized into two groups:A group and B group．A group adopted restrictive fluid regimen and B group adopted tradition fluid regimen. To apply fluid according to monitoring of CVP and MBP to maintain a setted range and compare the oxygenation index，heart rate，bload lacticacidosis 1eve1 and urine volume in the two groups. Results：After 3 day treatment，the oxygenation index，urine volume were significantly increased and heart rate，bkxxtlactic acidosis level were significantly decreased A group．the difference of the index was statistically significant（P<0.05）, the hospital mortality in A group is lower than B group.Conclusion：According to CVP and MBP restrictive fluid regimen was safe and effective in the ARDS patients receiving mechanical ventilation,and can reduce the hospital mortality.