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Noninvasive Positive Pressure Ventilated Recruitment Maneuvers in the Early Stage of Acute Respiratory Distress Syndrome

Author: LiPanShi
Tutor: HuangJiJian
School: Chongqing Medical University
Course: Emergency Medicine
Keywords: Adult patients with acute respiratory distress syndrome Non-invasive ventilation Alveolar recruitment
CLC: R563.8
Type: Master's thesis
Year: 2007
Downloads: 42
Quote: 0
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Abstract


Objective: To investigate the use of noninvasive positive pressure ventilation (NPPV) alveolar recruitment (RM) feasibility , efficacy, safety and early adult respiratory distress syndrome (ARDS) patients . Methods: between May 2006 to February 2007 due to a variety of lung exogenous factors lead to ARDS admitted to the ICU patients 19 cases within 72 hours of the onset of the to ICU admission basis of NPPV 1 hour after RM applications inspiratory positive airway pressure (IPAP ) 20 cmH20 expiratory positive airway pressure ( EPAP ) 20 cmH20 for 2 minutes , observed RM , RM 30 points , one hour after the RM , RM 3 hours after arterial blood gas indicators , such as pH value , arterial carbon dioxide changes in pressure (PCO2), arterial blood oxygen partial pressure ( PO2 ) oxygenation index (PO2/FiO2) , and hemodynamic indicators such as patients with heart rate ( HR ) , mean arterial pressure ( MAP ) , peripheral blood pressure (BP) . Results: 2 patients because it is not a high tolerance RM airflow sense of the impact and exit , the remaining 17 patients was well tolerated . 30 minutes after RM the PO2 from RM 72.12 ± 11.51mmHg ago to rise to the 107.47 ± 15.77mmHg, PO2/FiO2 by the RM rise to 238.34 ± 159.00 ± 24.56 mmHg before 40.41mmHg . RM 30 minutes after of PO2, PO2/FiO2 and RM ago compared to a statistically significant difference ( P lt; 0.001 ) ; RM before and still statistically significant ( P lt; 0.01 ) ; RM RM 1 hour after 3 hours after the PO2, PO2/FiO2 falls close to RM before . Patients HR, MAP, BP and other indicators as well as the PH value , PCO2 between RM before and after the period of time was not statistically significant ( P gt; 0.05 ) . Conclusion: using IPAP 20 cmH20 EPAP 2 minutes RM 20 cmH20 keep NPPV therapy is effective in early ARDS patients , feasible , safe . Short time ( 3 hours ) to improve oxygenation index, basically no adverse effects on patients .

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CLC: > Medicine, health > Internal Medicine > Respiratory system and chest diseases > Pulmonary disease > Respiratory failure
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