Mechanical ventilation for treating severe multiple trauma

Objective To discuss the treatment of severe multiple trauma by mechanical ventilation in ICU.Methods Data on 60 cases of severe trauma treated by mechanical ventilation were reviewed,focusing on indicators involving therapeutic mode by breathing machine,tidal volume,blood gas analysis,routine test of blood,X ray.In addition,development of respiratory function was also observed,including degree of acute lung injury,duration of mechanical ventilation,death or survival.Results Patients received volume resuscitation within 24 hours following admitting ICU,and 10 patients received mechanical ventilation by 72 hours.There was no acute lung injury in patients with lower tidal volume.But for higher tidal volume patients,sepsis was observed in 24 cases,multiple organ dysfunction in 24 cases,abdominal compartment syndrome in 8 cases.The hospitalization of 60 patients was 3-34 days.Eight patients died due to herniation of brain in 3 cases,hemorrhagic shock combined with diffuse intravascular coagulation in 1 case,MODS in 3 cases,asystole in 1 case.Lung protective strategies with applying low tidal volumes and limited fluid resuscitation,controlling systemic inflammation response and increasing immunization were recommended to prevent tidal alveolar collapse and over distension in patients with severe multiple trauma.Conclusion Lung-protective ventilation strategy with lower tidal volume remains an important clinical tool for respiratory support.Effective and proper mechanical ventilation can decrease the incidence of lung injury related to breathing machine.