压力控制法肺复张在肺保护通气策略治疗ARDS中的应用

The Influence of Recruitment Maneuvers With Pressure Control Ventilatio On Lung Recruitment Effect Of Patients With ARDS

目的:研究应用压力控制通气方式的肺复张手法对ARDS患者肺复张效果的影响。方法:34例ARDS病人实施气管插管机械通气,采用压力控制小潮气量肺保护性通气策略,根据压力一容积曲线低位拐点(LIP)设置"最佳PEEP"为LIP+2cmH2O,维持吸入氧浓度≤0.60。都采用压力控制法肺复张技术。结果:治疗前后患者的一般情况(包括性别、平均年龄、HR、MAP、RR等)差异均无统计学意义。与PAC-RM前相比,RM后各时点PaO2、PaO2/FiO2均显著性升高(P<0.05)。结论:压力控制通气方式的肺复张手法可显著增加ARDS患者的动脉氧分压(PaO2)和氧合指数(PaO2/FiO2)。

Objective： To evaluate the influence of recruitment maneuvers（RM）with pressure control ventilation（PCV） on Lung recruitment effect of patients with ARDS.Method： 34 cases of tracheal intubation mechanical ventilation in ARDS patients,using pressure controlled small tidal volume of lung protective ventilation strategies,according to the pressure-volume curve of low turning point（LIP） set ＂best PEEP＂ for LIP＋2 cmH2O,maintaining the inspired oxygen fraction≤0.60.Recruitment maneuvers（RM）with pressure control ventilation（PCV）.Results： patients before and after recruitment maneuvers in General（including gender,mean age,HR,MAP,RR,and so on） differences were not statistically significant.Compared with before PAC-RM,PaO2,PaO2/FiO2 are significantly elevated（P0.05）;Conclusions： recruitment maneuvers（RM）with pressure control ventilation（PCV） can significantly increase arterial partial pressure of oxygen（PaO2） and oxygenation index（PaO2/FiO2）.