肺复张策略在急性呼吸窘迫综合征患者机械通气中的应用研究

目的:探讨急性呼吸窘迫综合征(ARDS)患者机械通气时应用肺复张策略的疗效与风险。方法:随机将ARDS患者分成两组:A组为对照组,B组为治疗组;两组均用PB840呼吸机采用Bilevel通气模式进行机械通气,原发病治疗相同;B组在A组的通气治疗基础上增加肺复张策略。记录开始前及24、48、72h的氧合指数(PaO2/FiO2)、二氧化碳分压(PaCO2)、是否出现气压伤并进行比对分析。结果:治疗组与对照组比较氧合指数12、24、72h均有明显改善,PaCO2在12、24、72h均有明显降低,而气压伤等并发症并无明显增加。结论:在ARDS机械通气患者中结合应用肺复张策略和Bilevel通气模式是安全有效的。

A clinical study of lung recruitment maneuvers in acute respiratory distress syndrome patients receiving mechanical ventilation

Objective:To discuss the effect and risk of the lung recruitment maneuvers in the acute respiratory distress syndrome(ARDS)patients.Methods:38 ARDS patients treated with the PB840 ventilator and with the same mode of Belevel were randomized into A and B groups.A group was the control group and the lung recruitment maneuvers have applied in the B groups.The oxygenation index and PaCO2 before and 24,48,72h after enrolling were measured and analyzed.And pulmonary barotrauma incidence were observed.Results:Compared with the control group,the oxygenation index had a significantly improvement and PaCO2 had a significantly decrease 24,48,72h after enrolling in the treatment group.However the pulmonary barotrauma and others complications did not increase.Conclusion:Combine the lung recruitment maneuvers with the mode of Belevel may be safe and effective at the ARDS patients receiving mechanical ventilation..