Value of Bedside Severe Ultrasound in Optimal Positive End-expiratory Pressure in Patients with Acute Respiratory Distress Syndrome
Objective To explore the value of bedside severe ultrasound on the optimal positive end-expiratory pressure(PEEP)in patients with acute respiratory distress syndrome(ARDS).Methods Sixty patients with ARDS admitted to the Intensive Care Unit,Anfu County People's Hospital from May 2021 to May 2023 were selected and divided into ultrasound group and control group by random number table method,with 30 patients in each group.The optimal PEEP was set by bedside severe ultrasound in the ultrasound group,and the lung recruitment therapy was carried out on this basis.The optimal PEEP was set by the best oxygen method in the control group,and the lung recruitment therapy was carried out on this basis.The oxygenation index(PaO2/FiO2),lung static compliance(CLst),lung dynamic compliance(Cdyn),PEEP,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,white blood cell count(WBC),procalcitonin(PCT),mechanical ventilation time and ICU treatment time were compared between the two groups.Results The PaO2/FiO2,CLst and Cdyn indexes of the two groups after lung recruitment were higher than those before lung recruitment,and the PaO2/FiO2,CLst and Cdyn indexes of the ultrasound group were higher than those of the control group(P＜0.05).On the third day of treatment,the PEEP index of the two groups was higher than that before treatment,the APACHE Ⅱ score was lower than that before treatment,and the PEEP index of the ultrasound group was higher than that of the control group,the APACHE Ⅱ score was lower than that of the control group(P＜0.05).The WBC and PCT indexes of the two groups on the 7th day of treatment were lower than those before treatment,and the WBC and PCT indexes of the ultrasound group were lower than those of the control group(P＜0.05).The mechanical ventilation time and ICU treatment time in the ultrasound group were shorter than those in the control group(P＜0.05).Conclusion Bedside severe ultrasound can achieve lung recruitment monitoring in patients with ARDS,and has a good guiding effect on the optimal PEEP setting.Meanwhile,it can effectively improve the oxygenation index of patients,improve their lung compliance,down-regulate the inflammatory indicators in vivo,and shorten the mechanical ventilation time and ICU treatment time of patients.
Acute respiratory distress syndromeBedside severe ultrasoundPositive end expiratory pressureLung complianceLung atelectasisPulmonary ventilation function
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