Clinical effect of lower tidal volume combined with sustained inflation on acute respiratory distress for post operative carcinoma surgery patients / 中国综合临床

ABSTRACT

Objective To study the clinical efficiency and possible side effects of lower tidal volume combined with sustained inflation(SI) on acute respiratory distress syndrome (ARDS) for post operative carcinoma surgery patients.Methods Fifty one hypoxemia post operative carcinoma surgery patients from Jan.2007 to Dec.2009 in Cancer Hospital and Institute,Chinese Academy of Medical Sciences and Peking Union Medical College were included.Their cirrculation was stable.Mechanical ventilation could not be removed due to ARDS.Noninvasive continuous artery blood pressure ( NBP),pulse oximetric saturation ( SPO2 ),arterial blood gas ( ABG ) analysis,static compliance of respiratory system (Cst) were monitored and recorded.Patients were ventilated on volume control mode.Tidal volumes (VT) was set to 6 ml/kg.SI were conducted by continuous positive airway pressure of 35 cm H2O,sustaining for 40 seconds.Positive end-expiratory pressure (PEEP),FiO2,respiratory rate (F),Pplateau inspiratory pressures (Pplat),the peak inspiratory pressures (Ppeak),VT,Cst and ABG before SI applying and at 10 min,24 h,48 h after SI applying were measured.Results The level of PaO2 and FiO2 were significantly lowered,VT and Crs increased significantly,Ppeak,Pplat,and F were improved significantly at 10 min,24 h and 48 h after SI in all cases.No complication occurred.All patients were discharged without adverse event.Conclusions Hypoxemia of ARDS following carcinoma surgery could be improved by lower tidal volume combined with SI.