摘要
目的 探讨低潮气量的肺保护性通气对烧伤合并重度吸入性损伤呼吸支持治疗的可行性及效果。方法 对1996年 1月～ 2 0 0 0年 12月入院的吸入性损伤后气管切开需机械通气 48h以上者 ,进行低潮气量 (6～ 8mL/kg)和适度PEEP模式的通气治疗。结果 共 34例接受治疗。 2 4例治愈 ,死亡 10例。所有幸存者通气 0 5～ 3h低氧血症即可纠正。结论 低潮气量的肺保护性通气适合重度吸入性损伤的呼吸支持治疗 ,可明显改善肺通气功能 ,降低ARDS及肺炎的发病率 ,长期机械通气后容易脱机。
Objective To determine the feasibility and effect of a low tidal volume strategy of lung protective ventilation on the burn patient with severe inhalation injury.Methods All admitted burn patients with inhalation injury who should required mechanical ventilation for over 48 hours were studied randomly in the period from January,1996 to December 2000.All of whom received tracheotomy and bronchoscopy. These patients were ventilated with a tidal volume of 6～8 mL per kilogram of body weight and optimal positive end-expiratory pressure(PEEP).Results Thirty-four patients were entrance into the clinical trial study (male 28,female 6).The average of body surface area burned was sixty-five per cent,mean age was thirty-five, and the mean ventilation time was 5 8±4 3 days (range from 2d to 15d).Twenty-four of 34 patients were cured and ten of 34 were died.The oxygen pressure of arterial blood was recovered normal level within half an hour to three hours after mechanical ventilation in the survived group.Conclusion It is acceptable for the burn patient with severe inhalation injury that low-tidal volume strategy of lung protective ventilation.The strategy can improve significantly the respiratory function,and minimize the morbidity of acute respiratory distress syndrome (ARDS) and pneumonia,and provide a higher rate of weaning from long-term mechanical ventilation
出处
《中国急救医学》
CAS
CSCD
北大核心
2001年第9期522-523,共2页
Chinese Journal of Critical Care Medicine
