Effects of lung protective ventilation on acute lung injury patients

Objective To observe the effects of lung protective ventilation in the patients with acute lung injury(ALI).Methods Forty patients suffering from ALI were mechanical ventilated(SIMV mode) and were randomized to receive traditional ventilation as control group or lung protective ventilation as lung protective ventilation group,respectively(n=20,respectively).Results of arterial blood gas,index of oxygenation(PaO_2/FiO_2),airway plateau pressure(P_(Plat)),inspiration peak pressure(P_(Peak)),compliance of respiration system(C_(rs)),positive end-expiration pressure(PEEP),intrinsic end-expiration pressure(PEEPi) and mortality of 28 days were recorded.Results PaCO_2 of the patients in the lung protective ventilation group were obviously increased after mechanical ventilated for 48 h than baseline [(48.6±3.5)mm Hg vs(37.7±3.1)mm Hg,P0.05)]and that of the control group(P0.05).Meanwhile,the pH of the lung protective ventilation group decreased obviously after ventilated 48 h [(7.25±0.16) vs(7.33±0.23),P0.05].PaO_2/FiO_2 of all patients were improved,but the improvement of the lung protective ventilation group were more significant than those in the control group after ventilated for 6 h(156±12 vs 146±15,P0.05).P_(Plat) and P_(Peak) of the control group were significantly higher than those in the lung protective ventilation group [after ventilation 24 h:(22.1±(1.3)cm H_2O) vs(16.6±2.1)cm H_2O,(28.3±3.7)cm H_2O vs(24.6±2.1)cm H_2O,respectively;after ventilation 48 h:(24.4±1.6)cm H_2O vs(16.5±1.7)cm H_2O,(31.7±3.5)cm H_2O vs(25.3±(2.3) cm H_2O),respectively,all P0.05].Although PEEPi were higher in the lung protective ventilation group,the difference was not significant(P0.05).There was no significant difference in mortality of 28 days between the lung protective ventilation group and the control group(10% vs 20%,P0.05).Conclusion Lung protective ventilation can improve oxygenation and do not increase mortality of ALI.