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《Chinese Journal of Critical Care Medicine》 2003-01
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Effect of sustained inflation on pulmonary gas exchange and oxygen metabolism in patients with acute lung injury

DENG Zhao-xia,WEN Liang,LIU Ming-hua. Department of Emergency,the South-West Hospital,the Third Military Medical University,Chongqing 400038, China  
Objective To observe the influence of sustained inflation(SI)combined with small tidal volume ventilation on pulmonary gas exchange and oxygen metabolism in patients with acute lung injury(ALI),and to investigate the effects of SI and the best pressure of SI.Methods 31 patients with severe trauma followed by acute lung injury were selected for this study.All patients were admitted to the intensive care unit(ICU)within 24 hours after ALI diagnoses and were mechanically ventilated.Firstly they underwent 1 h of small tidal volume ventilation(baseline) and then 1 h of SI with 20 cmH 2O×30 s(SI 1),30 cmH 2O×30 s(SI 2),40 cmH 2O× 30 s(SI 3),50 cmH 2O×30 s (SI 4)respectively.Parameters of pulmonary gas exchange and oxygen metabolism were measured at 1 h of baseline?1 h of SI and 1 h of returning baseline.Results All the parameters indicated that there were no significant differences after SI 1 and SI 2 compared with baseline,but PaO 2 increased significantly after SI 3 and SI 4〔from(92 0±14 2)mmHg to (121 3±16 9)mmHg and (120 4±17 0)mmHg respectively, P 0 01〕.After SI 3 and SI 4 oxygen delivery index(DO 2I)increased significantly,pulmonary venous mixture(Qs/Qt)decreased significantly.After SI interruption,all the physiological variables returned to baseline.We found that there were no significant difference in improvement of oxygenation between SI 3 and SI 4.Conclusions Treatment of SI combined with small tidal volume ventilation for the patients with acute lung injury could improve pulmonary gas exchange and oxygenation.40 cmH 2O was the best pressure of SI.
【CateGory Index】: R563.8
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