The Study On Effects Of Lung Recruitment Maneuvers In Patients With Acute Respiratory Distress Syndrome

Objective:To investigate the clinical effects and safety of recruitment maneuvers (RM) combined with lung protective strategy in patients with acute respiratory distress syndrome (ARDS).Methods:14acute respiratory distress syndrome(ARDS) patients caused by multiple diseases in intensive care unit(ICU)were enrolled in this study from November2010to October2011.To observe the influence of RM(PCV) on hemodynamics, pulmonary mechanics and gas exchange in14patients with ARDS,RM using a pressure of45cmH2O(PC25cmH2O,PEEP20cmH2O) was applied for60s,a totel of20times.Results:1.After RM treatment,both oxygenation index and partial pressure of arterial oxygen(PaO2) were significantly increased in15min,1hr and2hr (P<0.05). There was no significant difference in the partial pressure of carbon dioxide (PaCO2) and PH value before and after RM(P>0.05).2.The peak inspiratory pressures (PIP) and mean airway pressure (Pm) decreased markedly at an hour and2hour later after RM(P>0.05), but respiratory system compliance (Crs) increased markedly at15minutes after RM (P<0.05). The Plateau inspiratory pressure(Pplat) decreased markedly at15minutes after RM.3.The central vein pressure (CVP) and heart rate(HR) increased during recruitment (P<0.05),The cardiac output and mean arterial pressure (MAP) decrease during recruitment (P<0.05),but there was no significant difference after RM(P>0.05).Conclusion:1.RM (PC25cmH2O,PEEP20cmH2O,applied for60s)can improve oxygenation,Crs and PaO2/FiO2and decreased the peak inspiratory pressures (PIP),mean airway pressure (Pm) and Plateau inspiratory pressure(Pplat) of the patients with ARDS in the basis of protective-ventilation strategy.2.This study also suggests that RM is safe for hemodynamics and did not lead to barotrauma...