The application of low tidal volume ventilation with positive end-expiratory pressure in patients with acute lung injury due to chest trauma

Objective To explore the effects of low tidal volume ventilation with positive end-expiratory pressure on the hemodynamic and oxygen metabolism in patients with acute lung injury (ALI) due to chest trauma.Methods 12 patients of ALI (score≥2.0) was ventilated with low tidal volume and positive end expiratory pressure (PEEP) at various levels of PEEP (0,5,10,15,20 cm H 2O).The parameters of hemodynamic and oxygen metabolism were monitored by Swan-Ganz catheter.Results In the range of PEEP from 5 to 10 cm H 2O the cardiac output (CO),cardiac index (CI) ,and MBP were gradually increased while heart rate (HR) was significantly decreased (P0.01).When the level of PEEP exceeded 15 cm H 2O CO and CI were significantly decreased meanwhile HR,PAP,SVR and PVR were significantly increased (P0.01).In the range of PEEP from 5 to 10 cm H 2O the compliance static (Cst) was gradually increased (P0.01) but significantly decreased at the level of PEEP exceeding 15 cm H 2O.Conclusion Low tidal volume ventilation with proper level of PEEP has minimal adverse effects on pneumodynamics and hemodynamic in patients with ALI resulted from chest trauma.