Comparison of two lung protective ventilation modes in severe traumatic wet lung with lung ventilation strategy / 中国医师进修杂志

ABSTRACT

Objective To compare the clinical effective of two lung protective ventilation modes in severe traumatic wet lung (STWL) with lung ventilation strategy.Methods Ninety-two cases of STWL patients were divided into adaptive support ventilation (ASV) group and pressure type synchronous intermittent aeration instruction (P-SIMV) + pressure support ventilation (PSV) group with 46 cases by random number table method in each.Heart rate,mean arterial pressure (MAP),pH value,arterial blood oxygen partial pressure (PaO2),arterial bold carbondioxide partial pressure (PaCO2),minute ventilation,tidal volume,total respiratory frequency,airway peak pressure and mean airway pressure,airway closure pressure,and pulmonary compliance at 30 min after mechanical ventilation were compared between two groups.Results At 30 min after mechanical ventilation,heart rate,MAP,pH value,PaO2,PaCO2 and mean airway pressure,airway peak pressure and airway closure pressure between two groups had no statistical significance (P ＞0.05).But tidal volume,minute ventilation,total respiratory frequency,pulmonary compliance in ASV group were obviously improved compared with those in P-SIMV + PSV group [(692.6 ± 38.6) mlvs.(558.5±25.6)ml,(8.9± 1.7) Lvs.(7.8± 1.6) L,(16.3±3.3) times/min vs.(21.3±3.2)times/min,(42.15 ± 5.28) ml/cmH2O (1 cmH2O =0.098 kPa) vs.(39.15±5.47) ml/cmH2O] (P ＜ 0.01 or ＜0.05).Conclusion For patients with STWL in the lung protective ventilation strategy,ASV can automatically adjust the level of inspiratory pressure support according to the respiratory mechanics condition of the patients,improving tidal volume and pulmonary compliance,and reducing respiratory rate,which has no obvious effect on the hemodynamics and vital signs.