Comparative study on therapeutic effects of airway pressure release ventilation and low tidal volume protective ventilation strategy on acute respiratory distress syndrome
Comparative study on therapeutic effects of airway pressure release ventilation and low tidal volume protective ventilation strategy on acute respiratory distress syndrome
Objective To compare the therapeutic effects of airway pressure release ventilation(APRV)and low tidal volume(LTV)protective ventilation strategy on acute respiratory distress syndrome(ARDS).Methods A retrospective analysis was per-formed on the clinical data of 200 patients with moderate to severe ARDS.Patients receiving APRV and LTV protective ventilation strat-egy were included in APRV group(n=97)and LTV group(n=103).The two groups were compared on blood gas indicators,the A-cute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score,the Murray lung injury score(MLIS),inflammatory factors,circu-latory function,and outcome of the disease.Results After 72 h of treatment,there were increases in partial pressure of oxygen(PaO2),blood oxygen saturation(SpO2)and oxygenation index(OI),and decrease in partial pressure of carbon dioxide(PaCO2)in both groups.Meanwhile,PaO2,SpO2 and OI in APRV group were higher than those in LTV group,and PaCO2 was lower than that in LTV group(all P＜0.05).After 72 h of treatment,APACHE Ⅱ scores and MLIS scores of both groups decreased,and APRV group had lower scores than LTV group(all P＜0.05).After 72 h of treatment,the levels of interleukin-6(IL-6),procalcitonin(PCT),C-reac-tive protein(CRP)and white blood cell count(WBC)in both groups decreased,and the levels in APRV group were lower than those in LTV group(all P＜0.05).After 72 h of treatment,there were decreases in central venous pressure(CVP)and heart rate(HR),and increases in cardiac output(CO)and mean arterial pressure(MAP)in both groups.Meanwhile,CVP and HR of APRV group were lower than those of LTV group.CO and MAP were higher than those of LTV group(all P＜0.05).The time to weaning and length of ICU stay in APRV group were shorter,and mortality rate was lower compared to LTV group(all P＜0.05).The incidence rates of com-plications in the two groups were close(P＞0.05).Conclusion Compared with LTV,APRV can better improve blood gas,inflam-matory response,circulatory function and pulmonary function in patients with ARDS.In addition,it can help to shorten the time to wea-ning and ICU stay,and lower the mortality rate,without increasing the incidence of complications.
维普
万方数据