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find Author "PengYigen" 1 results
  • Application of Adaptive Support Ventilation Plus Lung Recruitment Maneuvers in Patients with Traumatic Brain Injuries Complicated with ARDS

    ObjectiveTo investigate the value of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) for patients with traumatic brain injuries combined with ARDS. MethodsThirty 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. ResultsCompared 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). ConclusionASV+LRM mode is better than SIMV in ventilation for traumatic brain injuried patients combined with ARDS.

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