Application of Adaptive Support Ventilation Plus Lung Recruitment Maneuvers in Patients with Traumatic Brain Injuries Complicated with ARDS_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 HanQiu , LiJing , PengYigen , DuYeping

Intensive Care Unit, Huai'an Second People's Hospital Affiliated to Xuzhou Medical College, Huai'an, Anhui, 223002, China;

Corresponding author：

HanQiu, Email: 108704880@qq.com

Keywords：

Acute respiratory distress syndrome; Trauatic brain injuries; Adaptive support ventilation; Lung recruitment maneuvers

DOI：

10.7507/1671-6205.2014062

Video：

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Objective To investigate the value of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) for patients with traumatic brain injuries combined with ARDS. Methods Thirty trauatic brain injuried patients combined with ARDS including 18 males and 12 females at age of 15-76 years were mechanically ventilated by SIMV+PSV or ASV+LRM.The patient was initially ventilated with SIMV for 8 hours,with tidal volume(VT)of 8 mL/kg,PEEP=0,oxygen inhalation concentration of 60%.Then,one of ASV+LRM and SIMV modes was randomly selected for continual ventilation.The positive end-expiratory pressure were set at three levels (PEEP 0,5 and 10 cm H₂O).Each level of PEEP was maintained for 60 minutes.During the use of ASV+LRM,pressure controlled ventilation (PCV) was at 40 cm H₂O and breath holding continued for 30 seconds.Then,the mode was turned to ASV.Respiratory mechanics,hemodynamics,blood gas,oxygen delivery,intracranial pressure and other indicators were measured when each level of PEEP was ventilated for 50 minutes. Results Compared with SIMV mode in the same level of PEEP,ASV+LRM mode had lower peak inflating pressure (PIP),airway plate pressure(Pplat) and intrapulmonary shunt(Qs/Qt),central venous pressure(CVP),intracranial pressure(ICP),but higher oxygenation index (PaO₂/FiO₂) and partial pressure of oxygen (PaO₂)(all P<0.05).There was no statistical difference in MAP between two modes (P>0.05). Conclusion ASV+LRM mode is better than SIMV in ventilation for traumatic brain injuried patients combined with ARDS.

Citation： HanQiu, LiJing, PengYigen, DuYeping. Application of Adaptive Support Ventilation Plus Lung Recruitment Maneuvers in Patients with Traumatic Brain Injuries Complicated with ARDS. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(3): 259-262. doi: 10.7507/1671-6205.2014062 Copy

1.	中华医学会重症医学分会.急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南.中华急诊医学杂志,2007,16:343-349.
2.	Laubscher TP,Frutiger A,Fanconi S,et al.The automatic selection of ventilation parameters during the initial phase of mechanical ventilation.Intensive Care Med,1996,22:199-207.
3.	Linton DM,Potgieter PD,Davis S,et al.Automatic weaning from mechanical ventilation using an adaptive lung ventilation controller.Chest,1994,106:1843-1850.
4.	Demaika TA,Keddissi JI,Kinasewitz GT.Update on ARDS:beyond the low tidal volume.Am J Met Sei,2009,337:360-363.
5.	Brower RC,Rubenfeld GD.Lung-protective ventilation strategies in acute lung injury.Crit Care Med,2003,31:312-316.
6.	Jia X,Malhotra A,Saeed M,et al.Risk factors for ARDS in patients receiving mechanical ventilation for>48 h.Chest,2008,133:853-861.
7.	Yang KL,TobinMJ.A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilationl.Engl J Med,1991,324:1445-1450.
8.	张纳新,王平,秦英智.11249例机械通气患者脱机失败原因分析.中国危重病急救医学,2001,12:116-117.
9.	邱海波,陈德昌.呼吸机脱机的指征手段及其评价.中国危重病急救医学,1996,8:377-380.

1. 中华医学会重症医学分会.急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南.中华急诊医学杂志,2007,16:343-349.
2. Laubscher TP,Frutiger A,Fanconi S,et al.The automatic selection of ventilation parameters during the initial phase of mechanical ventilation.Intensive Care Med,1996,22:199-207.
3. Linton DM,Potgieter PD,Davis S,et al.Automatic weaning from mechanical ventilation using an adaptive lung ventilation controller.Chest,1994,106:1843-1850.
4. Demaika TA,Keddissi JI,Kinasewitz GT.Update on ARDS:beyond the low tidal volume.Am J Met Sei,2009,337:360-363.
5. Brower RC,Rubenfeld GD.Lung-protective ventilation strategies in acute lung injury.Crit Care Med,2003,31:312-316.
6. Jia X,Malhotra A,Saeed M,et al.Risk factors for ARDS in patients receiving mechanical ventilation for>48 h.Chest,2008,133:853-861.
7. Yang KL,TobinMJ.A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilationl.Engl J Med,1991,324:1445-1450.
8. 张纳新,王平,秦英智.11249例机械通气患者脱机失败原因分析.中国危重病急救医学,2001,12:116-117.
9. 邱海波,陈德昌.呼吸机脱机的指征手段及其评价.中国危重病急救医学,1996,8:377-380.

Chinese Journal of Respiratory and Critical Care Medicine

Application of Adaptive Support Ventilation Plus Lung Recruitment Maneuvers in Patients with Traumatic Brain Injuries Complicated with ARDS

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