ObjectiveTo explore the safety of ventilator support in hyperbaric oxygen chamber and the prevention of related complications.MethodsFrom July 2016 to December 2018, there were 127 intensive care unit patients underwent hyperbaric oxygen therapy with ventilator. Medical professionals in hyperbaric medicine or intensive care medicine were arranged to accompany the patients in the treatment process, to observe the patients’ condition changes closely, monitor their heart rate, respiration, blood pressure, and oxygen saturation, and perform sputum suction at any time if needed and monitor the airway peak pressure change to prevent pneumothorax.ResultsDuring the process of hyperbaric oxygen therapy, 13 patients (10.24%) were treated with analgesia/sedation for patient-ventilator asynchrony, 4 patients (3.15%) exited the champer emergently for acute left heart failure, 3 patients (2.36%) had epileptic seizures, 3 patients (2.36%) had aspiration, and 1 patient (0.79%) had breath and cardiac arrest. After emergency treatment, all the patients returned to the ward safely.ConclusionDuring the treatment of hyperbaric oxygen therapy for intensive care unit patients with ventilator, the accompany of qualified professionals in hyperbaric medicine or intensive care medicine in the hyperbaric oxygen chamber can treat the patients’ symptoms timely and reduce the risk greatly.
Objective To investigate whether the new oxygenation index [ PaO2 /( FiO2 ×Paw ) ]which including mean airway pressure ( Paw ) for assessing intrapulmonary shunting of acute respiratory distress syndrome( ARDS) could be more accurate than the conventional oxygenation ratio ( PaO2 /FiO2 ) .Methods Twelve patients with ARDS were recruited. All patients received mechanical ventilation under lung ventilation protective strategy ( VT 6 mL/kg, f 16 bpm, FiO2 60% ) , and had a Swan-Ganz catheter inserted. Then, pressure/ volume curves were determined by low-flow method and the lower inflection point pressure was surveyed. Subsequently, parameters of respiratory mechanics and haemodynamics were recorded while periphery and pulmonary artery blood gas analysis were performed when positive end expiratory pressure ( PEEP) were changed. PaO2 /FiO2 and Qsp/Qt were calculated through special formula respectively. Results The progressive PEEP could not change Cst, PaO2 /FiO2 , and PaO2 / ( FiO2 ×Paw) in patients with ARDS significantly ( P gt; 0. 05) . The progressive PEEP did not change Qsp/Qt significantly ( P gt;0. 05) . The Δz which was used to test the difference between the correlation coefficient of Qsp/Qt and PaO2 / ( FiO2 ×Paw) and the correlation coefficient of Qsp/Qt and PaO2 /FiO2 was 0. 571, and there was no difference between the two correlation coefficients ( P gt; 0. 05) . It was not Paw but Cst which impacted on Qsp/Qt and PaO2 /FiO2 . Conclusion PaO2 / ( FiO2 × Paw ) is equal to PaO2 /FiO2 in assessing intrapulmonary shunting of ARDS.