Comparison Of Effects Of Two Recruitment Maneuver Modes On The Respiratory And Hemodynamics In Patients With Acute Respiratory Distress Syndrome Patients-meta Analysis

Objective:To systematically evaluate the effects of two modes of recruitment maneuver?RM?-sustained inflation?SI?and pressure control ventilation?PCV?on the respiratory and hemodynamics with acute respiratory distress syndrome?ARDS?patients.Methods:In online retrieval,the randomized controlled trial?RCT?of comparing the effects of SI and PCV on the respiratory and hemodynamics with ARDS patients were searched in Chinese and English databases.The subjects were adults with a time range of 1970-2018.Based on the inclusion and exclusion criteria,the literatures were strictly screened,and meanwhile the Revman 5.3 software was used to evaluate the migration risk of the included research.After data extraction,Stata 12.0 software was used for data analysis.A total of 14 indicators are in the final analysis of statistics.Respiratory indexes were included by oxygen partial pressure?PaO₂?,partial pressure of carbon dioxide?PaCO₂?,oxygenation index,pulse oxygen saturation,function residual capacity,static compliance,dynamic compliance,platform pressure,peak airway pressure.And hemodynamics were included by heart rate,mean arterial pressure,central venous pressure,cardiac index and extravascular lung water.Results:13 RCT studies were included with a total of 506 adult ARDS patients.Data analysis results:Compared with the SI mode,PCV mode improve PaO₂?SMD=-0.186,95%CI:-0.328^-0.045,P=0.01<0.05?,improve the oxygenation index of 20 min after recruitment?SMD=-0.758,95%CI:-1.259^-0.257,P=0.003<0.05?,improve pulse oxygen saturation after 5 min of recruitment?SMD=-1.195 95%,95%CI:-2.215^-0.175,P=0.022<0.05?,and improve the dynamic compliance?SMD=-0.498,95%CI:-0.928^-0.067,P=0.023<0.05?.PCV mode also increase the cardiac index?SMD=-0.291,95%CI:-0.536^-0.046,P=0.020<0.05?and increase mean arterial pressure in the process of recruitment?SMD=-0.962,95%CI:-1.812^-0.112,P=0.027<0.05?.Conclusion:The PCV mode is superior to the SI mode on improving the oxygenation index and lung dynamic compliance of ARDS patients,and elimate the inhibition to cardiac index and mean arterial pressure than that of the SI mode,so that hemodynamics is more stable.