Application of low tidal volume with positive end-expiratory pressure to patients with chest trauma due to acute lung injuries

Objective:To explore the influence of low tidal volume with positive end expiratory pressure on the hemodynamics and metabolism of oxygen in patients with chest trauma resulting from acute lung injuries(ALI).Methods:Twelve patients of ALI(score≥2.0) were ventilated with low tidal and an increased positive end expiratory pressure(PEEP) (0,5,10,15,20 cmH 2O).The parameters of hemodynamics and metabolism of oxygen were obtained by Swan Ganz.Results:As the levels of positive end expiratory pressure(PEEP) were within 5 to 10 cmH 2O,the cardiac output(CO),cardiac index(CI) and mean blood pressure(MBP) were gradually increased,but HR were significantly decreased( P 0.01).At the levels of PEEP exceeded 15 cmH 2O,the CO and CI were significantly decreased and at the same time HR,pulmonary arterial pressure(PAP),systemic vascular resistance(SVR) and pulmonary vascular resistence(PVR) were significantly increased( P 0.01 ).As the levels of PEEP were within 5 to 10 cmH 2O,the compliance statics(Cst) were gradually increased( P 0.01).The Cst were significantly decreased when the levels of PEEP exceeded 15 cmH 2O.Conclusions:PEEP(5 to 10 cmH 2O) can be applied to patients with chest trauma due to ALI and to decrease the bad effects of pneumodynamics and hemodynamic.