Comparative Study for Clinical Effect on Severe Pneumonia between Prone-position and Supine-position Mechanical Ventilation

Objective To compare the clinical effect on severe pneumonia between prone-position and supine-position mechanical ventilation.Methods A total of 56 patients with severe pneumonia were selected in the 92 ed Hospital of Chinese People's Liberation Army from April 2012 to November 2014,and they were randomly divided into A group and B group,each of 28 cases.Patients of A group received routine supine-position mechanical ventilation,while patients of B group received prone-position mechanical ventilation under the help of 3 medical staffs,and percussion on back or vibration sputum elimination was used to assist the mechanical ventilation.Before treatment and on the fifth day of treatment,Pa O2,Pa CO2,MAP,dynamic lung compliance(Cdyn),serum levels of IL-8 and TNF-α,blood lactic acid level,APACHEⅡ score and heart rate were compared between the two groups.Results No statistically significant differences of Pa O2,Pa CO2,MAP or Cdyn was found between the two groups before treatment(P 0.05); on the fifth day of treatment,Pa O2 and Cdyn of B group were statistically significantly higher than those of A group,Pa CO2 of B group was statistically significantly lower than that of A group(P 0.05),while no statistically significant differences of MAP was found between the two groups(P 0.05).No statistically significant differences of serum level of IL-8 or TNF-α,or blood lactic acid level was found between the two groups before treatment(P 0.05); on the fifth day of treatment,serum TNF-α level and blood lactic acid level of B group were statistically significantly lower than those of A group(P 0.05); serum levels of TNF-α and IL-8 were statistically significantly higher than those before treatment,and blood lactic acid level of A group were statistically significantly lower than that before treatment(P 0.05),while no statistically significant differences of serum level of TNF-α or IL-8 of B group was found before and after treatment(P 0.05).No statistically significant differences of APACHEⅡ score or heart rate was found between the two groups before treatment(P 0.05); on the fifth day of treatment,APACHE Ⅱ score and heart rate of B group were statistically significantly lower than those of A group(P 0.05).Conclusion Prone-position mechanical ventilation has better clinical effect than supine-position mechanical ventilation in treating severe pneumonia,can more effectively improve the lung function without exacerbation of local inflammatory response.