The Different Strategies of Invasive Mechanical Ventilation in the Treatment of Traumatic ARDS

Objective To compare the efficacy of mechanical ventilation (MV) with low tidal volume (LTV) plus positive expiratory end pressure (PEEP) and conventioal MV in the treatment of traumatic acute respiratory distress syndrome(ARDS). Methods From Oct 1997 to Oct 2003, 26 cases of traumatic ARDS patients were treated by conventioal MV(group A, n=11) or MV with LTV plus PEEP(group B,n=15), and clinical data of the patients were recorded and compared. Results There were no statistical difference in the PaO 2 of blood gas analysis and hemodynamic indices between the two groups, while the PaCO 2 was higher in group B than that in group A(P0 05). The incidence of MODS and mortality of ARDS in group B were lower than those in group A, the latent period of MODS occurrence in group B were longer than that in group A(P0 05), and there was not the occurrence of VILI in group A. Conclusion MV with LTV plus PEEP could attain the same effect in improving oxygen saturation as traditional MV, and PEEP(5-18cmH 2O) and slight hypercapnia had not obvious influence on hemodynamic index, MV with LTV plus PEEP could prevent VILI, postpone the occurrence of MODS and reduce the incidence of MODS and mortality of ARDS, which is suitable for treating ARDS.