Ulinastatin combined with recruitment maneuver for extrapulmonary acute respiratory distress syndrome / 第二军医大学学报

ABSTRACT

Objective To explore the clinical effect of ulinastatin combined with recruitment maneuver on extrapulmonary acute respiratory distress syndrome (ARDS). Methods Forty-two patients with extrapulmonary ARDS, who received ulinastatin combined with recruitment maneuver in Eastern Hepatobiliary Surgery Hospital of Second Military Medical University from Jun. 2014 to Jun. 2016, were assigned to experimental group; and 45 patients with extrapulmonary ARDS, who were treated by recruitment maneuver without ulinastatin at the same time, were taken as control group. The blood gas analyzer was used to record radial arterial oxygen partial pressure (PaCO2), carbon dioxide partial pressure (PaCO2) and oxygenation index (OI) before and after treatment in the two groups; the breathing machine was used to record the inspiratory peak pressure (PIP), plateau pressure (Pplat), static lung compliance (Cs) and dynamic lung compliance (Cd); and ELISA was used to detect the serum levels of IL-6, TNF-α and IL-10. Results PaCO2 on 2nd, 3rd, 5th, 6th and 7th day after treatment, PaCO2 on 1st, 3rd, 5th and 7th day after treatment, and OI on 6th and 7th day after treatment in the experimental group were higher than those in the control group (all P<0.05). After treatment, PIP and Pplat in the two groups were significantly decreased (P<0.05), and Cs and Cd were significantly increased (P<0.05); the changes in the experimental group were significantly greater compared with the control group (P<0.05). In the experimental group and the control group, IL-6 and TNF-α levels were significantly decreased (P<0.05), and IL-10 levels were increased (P<0.05) after treatment; the changes in the experimental group were significantly greater compared with the control group (P<0.05). Conclusion Ulinastatin combined with recruitment maneuver can more effectively reduce lung injury and improve pulmonary ventilation of the patients with extrapulmonary ARDS compared with simple recruitment maneuver.