Mechanical ventilation treatment for severe thoracic and abdomenal trauma complicated by acute respiratory distress syndrome

Objective To summarize and discuss the therapeutic strategies of mechanical ventilation for severe thoracic and abdomenal trauma complicated by acute respiratory distress syndrome(ARDS).Methods Ninety cases of severe thoracic and abdomenal trauma complicated by ARDS were reviewed.Thirty-eight cases received traditional mechanical ventilation therapy,and 52 cases received pulmonary protective ventilation.The ventilator-carried time,oxygenation,the incidence of ventilator-associated lung injury(VALI) and fatality rate were compared between two strategies of mechanical ventilation.Results In patients treated with traditional mechanical ventilation,average ventilator-carried time was(7.56±2.49)days,oxygen index was(276.58±24.20),the incidence of VALI was 44.74%,and fatality rate was 34.21%.In patients treated with pulmonary protective ventilation,average ventilator-carried time was(5.47±2.81)days,oxygen index was(362.38±27.66),the incidence of VALI was 19.23%,and fatality rate was 13.46%.Compared with traditional mechanical ventilation,the therapeutic strategies of pulmonary protective ventilation shorten ventilator-carried time,improved oxygenation,reduced the incidence of VALI and the fatality rate.Conclusion Pulmonary protective ventilation in treating severe thorax and abdomen trauma complicated by ARDS is more effective than traditional mechanical ventilation,and should be applied clinically.