Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARD...Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H<sub>2</sub>O, P low starting at 4 cm H<sub>2</sub>O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ΔP value was adjusted according to VT. Pressure levels were increased by 2 cm H<sub>2</sub>O until a maximal V<sub>T</sub> was observed. Inspired oxygen fraction (FIO<sub>2</sub>) was 1.0 and tidal volume (V<sub>T</sub>) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured;visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (P P 2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.展开更多
目的探究牛肺表面活性剂联合高频振荡通气(high frequency oscillatory ventilation,HFOV)与牛肺表面活性剂联合常频通气对新生儿呼吸窘迫综合征血气指数及安全性的影响。方法收集2019年1月1日—2020年9月30日在本院出生并确诊为呼吸窘...目的探究牛肺表面活性剂联合高频振荡通气(high frequency oscillatory ventilation,HFOV)与牛肺表面活性剂联合常频通气对新生儿呼吸窘迫综合征血气指数及安全性的影响。方法收集2019年1月1日—2020年9月30日在本院出生并确诊为呼吸窘迫综合征的新生儿100例,不限性别。随机将其分为牛肺表面活性剂联合高频震荡通气治疗组(高频组)和牛肺表面活性剂联合常频通气(常频组),每组50例。观察两组新生儿治疗近期各时段的二氧化碳分压(partial pressure of carbon dioxide,PaCO2)和氧合指数(oxygenation index,OI),机械通气时间、氧暴露时间,治疗后并发症发生率。结果高频组治疗后2 h,12 h,24 h OI及PaCO2均低于常频组,比较差异均有统计学意义(P<0.05);高频组机械通气时间(无创及有创)、氧暴露时间均低于常频组,比较差异均有统计学意义(P<0.05);两组患儿病死率比较无统计学意义(P>0.05);两组患儿并发症比较发现,高频组支气管肺发育不良(bronchopulmonary dysplasia,BPD)、脑室内出血(intraventricular hemorrhage,IVH)发生率(0%、0%)与常频组(4.00%、0%)比较差异无统计学意义(P>0.05),脑室周围白质软化(periventricular leukomalacia,PVL)、肺气漏发生率(0%、2.00%)均低于常频组(14.00%、16.00%),差异均有统计学意义(P<0.05)。结论HFOV联合牛肺表面活性剂较常频通气联合牛肺表面活性剂在血气指数、机械通气时间方面均存在优势,并在减少BPD和肺气漏发生方面更具有显著作用。展开更多
文摘Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H<sub>2</sub>O, P low starting at 4 cm H<sub>2</sub>O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ΔP value was adjusted according to VT. Pressure levels were increased by 2 cm H<sub>2</sub>O until a maximal V<sub>T</sub> was observed. Inspired oxygen fraction (FIO<sub>2</sub>) was 1.0 and tidal volume (V<sub>T</sub>) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured;visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (P P 2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.
