Effect of conventional and low tidal volume ventilation on acute respiratory distress syndrome induced by trauma
Yusufujiang Yakufu
Xiaokelaiti Huojiahemaiti
Paerhati Baiheti
Abstract：Objective To explore the effect of conventional and low tidal volume ventilation on acute respiratory distress syndrome (ARDS) induced by trauma.Methods Totally 64 patients with ARDS undergoing mechanical ventilation from March 2012 to January 2014 were retrospectively analyzed.The patients were divided into conventional group (28 cases) with mechanical ventilation tidal volume of 10-12 ml/kg and unconventional group (36 cases) with mechanical ventilation tidal volume of 6-8 ml/kg.The arterial partial pressure of oxygen/ inspired oxygen concentration ratio (PaO2/FiO2),partial pressure of arterial carbon dioxide (PaCO2),pH value immediately,24,48 and 96 h after ventilation,the levels of tumor necrosis factor alpha (TNF-α) and interleukin (IL)-6 in arterial blood and bronchoalveolar lavage fluid levels immediately and 96 h after ventilation were compared between the two groups;the incidences of multiple organ dysfunction syndrome (MODS),ventilator induced lung injury (VILI) and mortality were compared between the two groups.Results Compared with those immediately after ventilation,the PaO2/FiO2 and PaCO2 were significantly increased 24,48,96 h after ventilation in unconventional group [(159±25),(178±31),(225±40) vs (106±29);(45±5),(48±5),(50±5) mmHg vs (39 ± 5) mmHg] (P ＜ 0.05).The levels of TNF-α,IL-6 in unconventional and conventional group 96 h after ventilation were obviously lower than immediately after ventilation in venous blood and bronchoalveolar lavage fluid [unconventional group TNF-α:(11.8 ± 2.1) ng/L vs (31.5 ± 3.3) ng/L,(10.3 ± 1.8) ng/L vs (25.1 ±3.0) ng/L,unconventional group IL-6:(13.5 ±2.4) ng/L vs (40.8 ±3.7) ng/L,(14.3 ±2.5)ng/L vs (36.1 ± 3.9) ng/L;conventional group TNF-α:(20.4 ± 3.4) ng/L vs (30.7 ± 3.2) ng/L,(17.5 ± 2.8) ng/L vs (24.8 ± 3.1) ng/L,conventional group IL-6:(24.8 ± 3.1) ng/L vs (41.5 ± 2.8) ng/L,(22.8 ± 2.8) ng/L vs (36.4 ± 3.4) ng/L],and unconventional group were significantly lower than conventional group (P ＜ 0.05).The incidences of MODS,VILI and mortality in unconventional group were significantly lower than those in conventional group [2.8％ (1/36) vs 17.9％ (5/28),5.6％ (2/36) vs 28.6％ (8/28),2.8％ (1/36) vs 17.9％ (5/28)] (P ＜ 0.05).Conclusion In treatment of traumatic ARDS,mechanical ventilation with small tidal volume can increase the PaO2/FiO2,,reduce the levels of TNF-α and IL-6 in venous blood and bronchoalveolar lavage fluid,and reduce the incidences of MODS,VILI and mortality.
Keywords：Respiratory distress syndrome,adultTidal volumeRespiration,artificial
Publication Date：2015-10-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：3( 1439-1441 )