The Effects of Lung Recruitment on Lung Oxygenation and Respiratory Mechanics in Patients with ARDS

Objective To research the effects of lung recruitment on lung oxygenation and respiratory mechanics in patients with acute respiratory distress syndrome (ARDS).Methods Thirty patients with ARDS from January of 2007 to August of 2008 were enrolled in the study.They were randomized into RM group(n=15) and non-RM group(n=15).The patients in RM group were treated with lung recruitment combined with low tidal volume lung protective ventilation (LPV) strategy.Those in non-RM group were treated with low tidal volume LPV strategy only.Arterial blood gas,respiratory mechanics and the SP level in serum in two groups were observed.Hemodynamic parameters in RM group were monitored with PiCCo care apparatus.Results (1)Compared with non-group,both PaO2 and PaO2/FiO2 in RM group increased more significantly,there were singnificant differences between two groups at 24,48 and 72 h post-ventilation (P0.01).(2)Both the PIP and the Pplat decreased significantly,whereas the Cst increased in RM group.There were significant differences between two groups at 24,48 and 72 h time intervals(P0.01).(3)RM could cause significant Hemodynamic parameters change till 120 seconds post-RM(P0.01).(4)The concentration of serum surfactant protein A(SP-A ) was negatively correlated with the Cst and PaO2/FiO2(r=-0.362,P0.05;r=-0.394,P0.05).The serum contents of SP-A were significantly different in two groups at 72 h post-ventilation(P0.05).Conclusion RM could recruit the collapsed alveolus in patients with ARDS.It could significantly improve lung compliance and oxygenation and decrease the serum contents of SP-A.The effects of RM on hemodynamics were temporary,thus RM was safe and effective for patients with ARDS.