Effect Of The Different Tidal Volume-mechanical Ventilation On Acute Respiratory Distress Syndrome

Objectives According to the the range of the tidal volume mechanical ventilation,the eighty patients who suffered from ARDS were divided into four groups in order to provide a clinical basis for the treatment of ARDS by comparing four different tidal volume mechanical ventilation of the clinical curative effect and prognosis on ARDS.Methods From November,2019 to September,2020 in the north China university of science and technology affiliated hospital,according to inclusion standard,we selected eighty patients with acute respiratory distress syndrome in Intensive Care Unit.All the patients were allocated into four groups:20 patients（group A）were given specific ventilation（VT 4m L/kg）,20patients（group B）were given specific ventilation（VT6m L/kg）,20 patients（group C）were given specific ventilation（VT 8m L/kg）,and 20patients（group D）were given specific ventilation（VT 10m L/kg）.The indicators such as blood gas analysis results（pH,PaO₂,PaCO₂,PO₂/FiO₂）and the vital signs（HR,MAP,CVP）were collected respectively at 0h（T₀）,24h（T₁）,48h（T₂）,72h（T₃）after mechanical ventilation.The indicators of the respiratory mechanics（Ppeak,Pplat,PEEP）were collected at T1～T₃time.To record and compare the the time of invasive mechanical ventilation,ICU hospitalization and total mortality between the four groups.Results The results reflects that the difference of age,gender,height,weight and acute physiology and chronic health evaluation Ⅱ between in the four groups was insignificant（P>0.05）.In group comparison:HR,MAP,CVP were lower than those at T₀ time（P<0.05）.The difference of MAP,HR and CVP between in the four groups at T₀ time was insignificant（P>0.05）.Group A and group B patients’vital signs were better than that of group C and group D the patients’vital signs at T₁～T₃ time,and the difference was statistically significant（P<0.05）.The difference between group A and group B patients’vital signs at T₁～T₃ time was insignificant（P>0.05）.The difference between in group C and group D patients’vital signs at T₁～T₃ time was insignificant（P>0.05）.In group comparison:PaCO₂ were lower than those at T₀ time（P<0.05）,while pH,PaO_2,PO₂/FiO₂were higher than those at T₀time（P<0.05）.There was no significant difference in pH,PaO₂,PaCO₂,PO₂/FiO₂ between the four groups at T₀ time（P>0.05）.Compared with the date of the group C respectively,the difference between the group A and the group C and the difference between the group B and the group C were statistically significant at T₁～T₃time（P<0.05）.Both the difference of blood gas analysis index between the group A and the group D and the difference of blood gas analysis index between the group B and the group D was significant at T₁～T₃ time（P<0.05）.Setting the results of blood gas analysis of the group A against those of the group B,we can not see a significant difference（P>0.05）.In the same way,we can not get a significant difference by comparing the group C with the group D（P>0.05）.It reflects that the date of the Ppeak and Plat in group A and group B were significantly lower than that in the group C and group D by comparing the four groups respectively at T₁～T₃ time（P<0.05）.The difference of the level of the PEEP between the four groups was insignificant（P>0.05）.The invasive mechanical ventilation time,and ICU stay time in group A and B were separately less than those in group C and D（P<0.05）.However,the difference between group A and B has no significance（P>0.05）,and the difference between group C and D has no significant（P>0.05）.Conclusions Compared to the larger tidal volume（8ml/kg,10ml/kg）mechanical ventilation treatment,it shows that the smaller tidal volume（4ml/kg,6ml/kg）mechanical ventilation treatment of acute respiratory distress syndrome may improve the successful rate of clinical treatment,and have positive clinical curative effect on ARDS.In the meantime,it can significantly improve the blood gas index,shorten hospitalization time and ventilation time and mortality rate.However,it needs to cost more intensive study because of the limitation of the sample size.Figure 0;Table 12;Reference 86...