Effect of prone position ventilation time on moderate to severe acute respiratory distress syndrome in children
Objective To investigate the effect of prone position ventilation(PPV)time on children pa-tients with moderate to severe acute respiratory distress syndrome.Methods Fifty-eight children patients with moderate to severe acute respiratory distress syndrome admitted and treated in the department of critical care medicine of a tertiary children's hospital in Shanghai City from June 2019 to June 2022 were selected as the study subjects.The clinical indicators[heart rate,pulse oximeter oxygen saturation(SpO2),mean arterial pressure(MAP),dynamic lung compliance(Cdyn),tidal volume(VT),peak inspiratory pressure(PIP),frac-tion of inspiration O2(FiO2),pH,arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2),bicarbonate radical(HCO3-),PaO2/FiO2(P/F),lactic acid]and adverse events occurrence(pressure injury,unplanned extubation)were collected before PPV,at PPV 6,12 h and at PPV＞12 h,on 1,2,3 d after PPV.The effects of PPV time on the vital signs,blood gas indexes,ventilator parameters and safety events in the children patients were observed.Results The incidence rate of pressure injury in this group of cases was 8.62％(5/58)and the incidence rate of tracheal intubation slip was 1.72％(1/58).SpO2,P/F,PaO2,FiO2,VT,Cdyn had statistically significant difference between before and after PPV on 1 d(P＜0.05),while the heart rate,MAP,PIP,pH,PaCO2,HCO3--and lactic acid had no statistical difference(P＞0.05).The comparative analysis of the patients with PPV time up to 3 d showed that the heart rate,SpO2,P/F,PIP and FiO2 after PPV all had significant improvement,moreover,with the PPV time increase,the P/F numerical value was increased more and more,while the need of FiO2 was lower more and more,and the differences were statistically significant(P＜0.05).Conclusion The effect of PPV for implementing a longer period of time is more obvious in improving the oxygenation status of children with moderate and severe ARDS,moreover which dose not increase the occurrence of safe events.
prone position ventilationacute respiratory distress syndromechildnursing care
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