Effect of early mechanical ventilation with continuous vacuum suction in treatment of serious pulmonary contusion / 中华创伤杂志

ABSTRACT

Objective To summarize the value of early mechanical ventilation plus continuous vacuum suction in treatment of serious pulmonary contusion.Methods Forty-eight cases of severe pulmonary contusion were assigned to mechanical ventilation plus continuous vacuum suction (observation group,n =20) and mechanical ventilation plus discontinuous vacuum suction (control group,n =28)according to the random number table.Modes of mechanical ventilation were synchronized intermittent mandatory ventilation (SIMV),pressure support ventilation (PSV),and positive and expiratory pressure (PEEP).Changes in blood gas analysis,mechanical ventilation time,and associated complications were compared between groups.Results At ventilation time of 6 and 24 hours,PaO2 in observation group was (100.36 ± 5.90) mmHg and (105.34 ± 7.40) mmHg respectively,with significant differences from (75.36 ± 8.95) mmHg and (76.36 ± 8.35) mmHg in control group (P ＜ 0.01).At ventilation time of 24 hours,PaO2/FiO2 was (283.50 ± 15.20) mmHg in observation group and (201.50 ± 10.20) mmHg in control group (P ＜0.01).Mechanical ventilation time and PEEP at ventilation time of 48 hours in observation group was (3.2 ± 1.1) days and (4.5 ± 2.3) cmH2 O,with significant differences from (6.5 ± 2.8) days and (8.5 ± 2.5) cmH2O in control group (P ＜ 0.01).Associated complications of the two groups revealed no significant difference (P ＞ 0.05).Conclusion Early mechanical ventilation with sustained vacuum suction is effective to keep airway clear,improve oxygenation index,decrease PEEP level,and control the duration of mechanical ventilation,but may not lower the risks of ventilator-associated pneumonia and pulmonary atelectasis.