The Investigation Of Mechanical Ventilation Pressure Parameters’ Effect On The Prognosis Of Acute Respiratory Distress Syndrome

Objective:To find out whether we can get the optimality in the prognosis of ARDS by combing the pressure parameters in mechanical ventilation with the traditional PaO2/FiO2.Methods:This is a retrospective study.Patients included here are diagnosed as ARDS in the Emergency Unit(EICU)of the First Affiliated Hospital of China Medical University from January 2018 to December 2018.All the patients were intubated and mechanical ventilated.Patients who were treated for too short time or lacked of obedience were excluded.According to the 28-day survival condition,patients were divided into survival and non-survival groups.Parameters in the two groups such as basic information,SOFA score,non-respiratory system SOFA score,PaO2/FiO2 were analyzed with independent sample t test or rank sum test.Simultaneously,plateau pressure,driving pressure,mean airway pressure and the ratio of these mechanical ventilation pressure parameters to the PaO2/FiO2 were also analyzed.Results:A total of 147 patients were included in the study and 117 of them were analyzed.The overall 28-day mortality was 31.62%(n=37).There were no significant differences in gender,age,body mass index,initial arterial oxygen partial pressure and carbon dioxide partial pressure between survival group and non-survival group(P>0.05).But there was a significant difference in SOFA score(6.53±2.96 vs 8.65±3.00),nR-SOFA(3.44±2.98vs 5.27±2.86).As for the evaluation index,the P_POI presented the largest AUC of 0.828,with the sensitivity 86.5%,and the specificity 71.2%.The AUC of the SOFA score was0.707,while the AUC of the P_POI combined with the SOFA score was 0.833.Conclusion:Mechanical ventilation pressure parameters can be used to predict the prognosis of patients with ARDS.P_POI is a good predictor for ARDS poor prognosis with the advantages of simpleness,timeliness and realtime.