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Clinical study on treating pulmonary edema with nitrous oxide inhalation combined with drugs and mechanical ventilation after seawater drowning

XU Xian-lin, LU Zhen-quan, WANG Jian,et al. The Seventh People's Hospital of Shenzhen City, Shenzhen 518081,China  
Objective To investigate the effectiveness of nitroic oxide (NO) of low concentration combined with three drugs and positive end-expiratory pressure mechanical ventilation in treating pulmonary edema caused by seawater drowning. Methods Fifteen patients were given nosal/facial mask Bi-level positive airway pressure ventilation plus scopolamine, naloxone and methylprednisolone (routine treatment group) . The other 12 patients were given NO (20×10-6) inhalation for 30 min except for routine treatment (synthetical treatment group). The pulmonary rales, the time of shadows on chest radiograph lasted, and the duration of disease of two groups were explored. Results In the synthetical treatment group, it took (0. 70±0. 56) d for pulmonary rales to disappear and (0. 58±0. 13) d for shadows on chest radiograph . And the disease had lasted for (2. 50±1. 30) d. While the above three guidelines in the routine treatment group were (2. 15±1. 66) d, (5.21±0.50) d and (5.80±3.00)d, respectively. The significant differences of the relevant data between the two groups were detected with a P value of 0.05, 0.01, 0. 01 accordingly. In addition,it was found that SaO2 values with NO inhalation treatment before and after were 79. 0%±8. 7% and 90. 0%±5. 5% , respectively. There were significant differences between them (t= 3. 72, P 0. 01 ). Conclusions These findings suggest that hypoxemia and pulmonary edema could be quickly improved by inhalation of NO at low concentration for a short time and treated with three drugs and positive end-expiratory pressure mechanical ventilation after seawater drowning. The approach is safe and effective.
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