Comparison Of Lung Protective-ventilation Strategy On Children With Pulmonary ARDS And Extra Pulmonary ARDS

ObjectiveTo observe the effect of lung protective ventilation on children with pulmonary acute respiratory distress syndrome and extra pulmonary acute respiratory distress.MethodsBetween January 2003 and December 2009,104 children with ARDS were enrolled from PICU of China Medical University affiliated Shengjing Hospital and assigned to pulmonary ARDS protective-ventilation group, pulmonary ARDS conventional-ventilation group, extra pulmonary ARDS protective-ventilation group and extra pulmonary ARDS conventional-ventilation group. The patients in pulmonary ARDS protective-ventilation group and extra pulmonary ARDS protective-ventilation group received lower tidal volume (6-8ml/kg) and high levels of positive end-expiratory pressure (PEEP), and optimal oxygenation was achieved by adjusting FiO2 and PEEP. The patients in pulmonary ARDS conventional-ventilation group and extra pulmonary ARDS conventional-ventilation group received relatively higher tidal volume (10-12ml/kg), and optimal oxygenation was achieved by adjusting mortality, number of ventilator days and in-patient days were compared between the four groups.ResultsAlthough mortality was lower and number of number of ventilator days and in-patient days were shorter in pulmonary ARDS protective-ventilation group, no significant differences were found between pulmonary ARDS protective-ventilation group and pulmonary ARDS conventional-ventilation group (P>0.05). But there were significant differences between extra pulmonary ARDS protective-ventilation group and extra pulmonary ARDS conventional-ventilation group (P<0.05).ConclusionLung protective ventilation may improve the outcome for pediatric patients with extra pulmonary acute respiratory distress than pulmonary acute respiratory distress, however, larger trials are required before a definite conclusion can be reached.