2010Chin J Postgrad MedRequires access

The study of protective ventilation strategy on severe pulmonary contusion

严四军, 刘燕, 曹祥, 乔德成, 邓波荣

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Abstract

Objective To investigate the effect of protective ventilation strategy on severe plumonary contusion. Methods Fifty-three patients suffered from severe pulmonary contusion were randomly divided into the protective ventilation group (25 cases,the tidal volume was 6-8 ml/kg) and the traditional ventilation group (28 cases,the tidal volume was 12-15 ml/kg). The blood gases were examined before and after ventilation. Moreover,the time for ventilation therapy,mortality rate and morbidity of complications were compared between the two groups. Results After ventilation,arterial oxygen content and oxygenation index were improved obviously in two groups,and there was no significant difference between the two groups. Average time for ventilation therapy and mortality rate in the protective ventilation group were (149.8 ±77.3) h and 28.0%(7/25),and those in the traditional ventilation group were (203.3 ± 85.2) h and 39.3% (11/28),there were significant difference between the two groups (P <0.01). The morbidity of pulmonary infection,pneumothorax and mediastinal emphysema in the protective ventilation group were significantly lower than those in the traditional ventilation group(P< 0.05 ). The morbidity of acute respiratory distress syndrome (ARDS) was no significant difference between the two groups (P >0.05). Conclusion Protective ventilation therapy for severe pulmonary contusion can effectively improve the pulmonary oxygenation function,increase arterial oxygen content,and markedly reduce the time for ventilation therapy,mortality rate,and morbidity of ventlation-associated complications. Key words: Respiratory distress syndrome,adult; Respiration,artificial; Intraoperative complication

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Objective To investigate the effect of protective ventilation strategy on severe plumonary contusion. Methods Fifty-three patients suffered from severe pulmonary contusion were randomly divided into the protective ventilation group (25 cases,the tidal volume was 6-8 ml/kg) and the traditional ventilation group (28 cases,the tidal volume was 12-15 ml/kg). The blood gases were examined before and after ventilation. Moreover,the time for ventilation therapy,mortality rate and morbidity of complications were compared between the two groups. Results After ventilation,arterial oxygen content and oxygenation index were improved obviously in two groups,and there was no significant difference between the two groups. Average time for ventilation therapy and mortality rate in the protective ventilation group were (149.8 ±77.3) h and 28.0%(7/25),and those in the traditional ventilation group were (203.3 ± 85.2) h and 39.3% (11/28),there were significant difference between the two groups (P <0.01). The morbidity of pulmonary infection,pneumothorax and mediastinal emphysema in the protective ventilation group were significantly lower than those in the traditional ventilation group(P< 0.05 ). The morbidity of acute respiratory distress syndrome (ARDS) was no significant difference between the two groups (P >0.05). Conclusion Protective ventilation therapy for severe pulmonary contusion can effectively improve the pulmonary oxygenation function,increase arterial oxygen content,and markedly reduce the time for ventilation therapy,mortality rate,and morbidity of ventlation-associated complications. Key words: Respiratory distress syndrome,adult; Respiration,artificial; Intraoperative complication

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Available abstract

Objective To investigate the effect of protective ventilation strategy on severe plumonary contusion. Methods Fifty-three patients suffered from severe pulmonary contusion were randomly divided into the protective ventilation group (25 cases,the tidal volume was 6-8 ml/kg) and the traditional ventilation group (28 cases,the tidal volume was 12-15 ml/kg). The blood gases were examined before and after ventilation. Moreover,the time for ventilation therapy,mortality rate and morbidity of complications were compared between the two groups. Results After ventilation,arterial oxygen content and oxygenation index were improved obviously in two groups,and there was no significant difference between the two groups. Average time for ventilation therapy and mortality rate in the protective ventilation group were (149.8 ±77.3) h and 28.0%(7/25),and those in the traditional ventilation group were (203.3 ± 85.2) h and 39.3% (11/28),there were significant difference between the two groups (P <0.01). The morbidity of pulmonary infection,pneumothorax and mediastinal emphysema in the protective ventilation group were significantly lower than those in the traditional ventilation group(P< 0.05 ). The morbidity of acute respiratory distress syndrome (ARDS) was no significant difference between the two groups (P >0.05). Conclusion Protective ventilation therapy for severe pulmonary contusion can effectively improve the pulmonary oxygenation function,increase arterial oxygen content,and markedly reduce the time for ventilation therapy,mortality rate,and morbidity of ventlation-associated complications. Key words: Respiratory distress syndrome,adult; Respiration,artificial; Intraoperative complication

Key concepts: Medicine, ARDS, Ventilation (architecture), Anesthesia, Pulmonary contusion, Pneumothorax, Tidal volume, Arterial blood

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