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Vol.1 , No. 1, Publication Date: Jul. 7, 2014, Page: 11-17
 on oxygenation and cardiac function in patients with acute respiratory distress syndrome while based on pressured controlled ventilation compared to the same treatment based on volume controlled ventilation. Methods: Patients with acute respiratory distress syndrome were enrolled and randomly divided into two groups (A, B). RMs were performed by stepwise increasing positive end-expiratory pressure. In group A, pressure controlled ventilation (PCV) mode was used for baseline readings. In group B, volume controlled ventilation (VCV) mode was used for baseline readings. Respiratory system mechanics and hemodynamic parameters were monitored before RMs and during the 2-h follow-up. PaO2/FiO2 and Qs/Qt were calculated from recorded blood gas analysis data. Levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-6, IL-8), and von Willebrand factor (vWF) in plasma and bronchoalveolar lavage fluid (BALF) were measured using ELISA. Results: Sixty-six patients with ARDS were enrolled. RMs based on VCV significantly increased PaO2/FiO2 and SPO2 and reduced Qs/Qt compared to these indicators based on PCV. RMs with patients both VCV and PCB significantly increased heart rate, while simultaneously reducing cardiac indices and stroke volume. All of these returned to basal level by the 2-h follow-up. The mean arterial pressure and peripheral systemic vascular resistance remained stable throughout the procedures for both kinds of ventilation. Neither VCV nor PCV RMs ventilation mode during RMs had any effect on the plasma or BALF levels of TNF-α, IL-1β, IL-6, IL-8, or vWF. Conclusion: Lung RMs based on VCV may improve hypoxemia effectually than PCV, by increasing oxygenation and reducing intrapulmonary shunt, with little side effect on hemodynamics, having no effect on inflammatory factor production.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Daihua Yu , Department of Anesthesiology, Tangdu Hospital of the Fourth Military Medical University, Xian, China. |
| [2] | Xude Sun , Department of Anesthesiology, Tangdu Hospital of the Fourth Military Medical University, Xian, China. |
| [3] | Lilong Yao , Department of Anesthesiology, Tangdu Hospital of the Fourth Military Medical University, Xian, China. |
Purpose: This study evaluated the effects of lung recruitment maneuvers (RMs) on oxygenation and cardiac function in patients with acute respiratory distress syndrome while based on pressured controlled ventilation compared to the same treatment based on volume controlled ventilation. Methods: Patients with acute respiratory distress syndrome were enrolled and randomly divided into two groups (A, B). RMs were performed by stepwise increasing positive end-expiratory pressure. In group A, pressure controlled ventilation (PCV) mode was used for baseline readings. In group B, volume controlled ventilation (VCV) mode was used for baseline readings. Respiratory system mechanics and hemodynamic parameters were monitored before RMs and during the 2-h follow-up. PaO2/FiO2 and Qs/Qt were calculated from recorded blood gas analysis data. Levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-6, IL-8), and von Willebrand factor (vWF) in plasma and bronchoalveolar lavage fluid (BALF) were measured using ELISA. Results: Sixty-six patients with ARDS were enrolled. RMs based on VCV significantly increased PaO2/FiO2 and SPO2 and reduced Qs/Qt compared to these indicators based on PCV. RMs with patients both VCV and PCB significantly increased heart rate, while simultaneously reducing cardiac indices and stroke volume. All of these returned to basal level by the 2-h follow-up. The mean arterial pressure and peripheral systemic vascular resistance remained stable throughout the procedures for both kinds of ventilation. Neither VCV nor PCV RMs ventilation mode during RMs had any effect on the plasma or BALF levels of TNF-α, IL-1β, IL-6, IL-8, or vWF. Conclusion: Lung RMs based on VCV may improve hypoxemia effectually than PCV, by increasing oxygenation and reducing intrapulmonary shunt, with little side effect on hemodynamics, having no effect on inflammatory factor production.
Keywords
Acute Respiratory Distress Syndrome, Lung Recruitment Maneuvers, Hypoxemia
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