Comparing The Effects Of Two Recruitment Maneuver Used In Patients With ARDS

Objective:To investigate and compare the effects and side effects on hemodynamics and respiratory mechanics of continuous positive airway pressure (CPAP) and pressure control ventilation (PCV) on lung recruitment in patients with acute respiratory distress syndrome (ARDS). Method:Ten patients with ARDS were included. Both maneuvers were successively applied in each patient under sedation, non-muscle relaxation state, first CPAP (40 cmH20,40 s), and then the PCV (20 cmH20,2 min). There was a elution period between two RMs. Parameters of pulmonary mechanics, gas exchange, and hemodynamics were measured before RM,5 min after RM and 1 h after RM. Parameters of pulmonary mechanics and hemodynamics were measured during RM. We observed oxygenation improvement and the impact of RM on hemodynamics, and respiratory mechanics. Results:(1) The FRC,PaO2/FiO2 5 mins after RM improved significantly comparing with the PaO2 before RM in two maneuvers (P<0.05), there was no significant difference between two maneuvers; the Cs,Plat,PCO2 5min,1h after RM improved significantly comparing with the PaO2 before RM in two maneuvers (P<0.05), there was no significant difference between two maneuvers; the EtCO2,R have no difference before or after RM(P>0.05). There was no difference between two methods (P>0.05)。(2) The MAP during RM decreased and HR increased significantly comparing with the MAPand HR before RM in two maneuvers (P<0.05). They recovered rapidly 5 mins after RM. There was no difference between two methods (P>0.05); the EtCO,R have no difference before or after RM(P>0.05). The CI has no difference before or after RM (P>0.05).The TFC decreased significantly comparing with the TFC before RM in two maneuvers (P<0. 05). It recovered rapidly 5 mins after RM in PCV group,not in SI group,but there was no significant difference between two maneuvers. Conclusions:The oxygenation, FRC, Cs during RM improve significantly both in CPAP and PCV, the effects are the same in two maneuvers. The HR,MAP have changed during RM but have no influence to the circulation and changed in normal range. The CPAP and PCV have the same impact on circulatory system during RM.