Effect of bronchopulmonary segments recruitment on the survival of patients with severe acute respiratory distress syndrome

doi:10.3877/cma.j.issn.1674-6902.2022.06.006

Abstract

Abstract:

Objective

To evaluate the effects of bronchopulmonary segments recruitment on clinical outcomes in patients with severe acute respiratory distress syndrome.

Methods

From April 2020 to April 2022, 30 patients with severe ARDS in our hospital were randomly divided into an observation group 17 cases and a control group 13 cases. All patients were given lung protective ventilation strategies and prone position, and the observation group was additionally given bronchopulmonary segments recruitment. The respiratory parameters, arterial blood gas, hemodynamic, complications and outcomes were compared between the two groups.

Results

After 72 hours of treatment, static compliance of the respiratory system, pH, the oxygenation index, stroke volume index in the observation group were higher than those of the control group(P<0.05). whereas positive end-expiratory pressure, partial pressure of carbon dioxide, the plateau pressure, extravascular lung water index, pulmonary vascular permeability index and mortality during hospital were lower than those of control group(P<0.05). No significant difference between the two groups were shown in the mean arterial pressure, heart rate, complications.

Conclusions

In patients with severe ARDS, based on lung protective ventilation strategy and prone ventilation, application of bronchopulmonary segments recruitment can improve the respiratory function, has little effect on hemodynamics, does not increase the complications such as pneumothorax and mediastinum emphysema. Therefore, bronchopulmonary segments recruitment can significantly improve the clinical outcomes of severe ARDS patients.

Key words: Bronchopulmonary segments recruitment, Acute respiratory distress syndrome, Balloon catheter

Zongjun Hu, Xi Yue, Xia Huang. Effect of bronchopulmonary segments recruitment on the survival of patients with severe acute respiratory distress syndrome[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(06): 796-800.

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References 32

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组　别	例数	PEEP(cmH₂O)		Pplat(cmH₂O)		C_Lst(ml/cmH₂O)
组　别	例数	入组时	72 h	入组时	72 h	入组时	72 h
观察组	17	16.11±4.23	8.23±2.14^a	29.56±7.32	20.32±5.15^a	29.33±15.49	38.87±13.31^a
对照组	13	16.32±3.13	10.37±3.22^a	29.57±6.34	23.68±6.38^a	30.18±14.62	34.75±14.34^a
P值		0.343	0.025	0.862	0.033	0.432	0.004

组　别	例数	PEEP(cmH₂O)		Pplat(cmH₂O)		C_Lst(ml/cmH₂O)
组　别	例数	入组时	72 h	入组时	72 h	入组时	72 h
观察组	17	16.11±4.23	8.23±2.14^a	29.56±7.32	20.32±5.15^a	29.33±15.49	38.87±13.31^a
对照组	13	16.32±3.13	10.37±3.22^a	29.57±6.34	23.68±6.38^a	30.18±14.62	34.75±14.34^a
P值		0.343	0.025	0.862	0.033	0.432	0.004

组　别	例数	pH		PaO₂/FiO₂(mmHg)		PaCO₂(mmHg)
组　别	例数	入组时	72 h	入组时	72 h	入组时	72 h
观察组	17	7.23±0.02	7.44±0.04^a	72.24±16.32	181.47±31.29^a	55.41±5.35	43.56±4.67^a
对照组	13	7.26±0.02	7.35±0.03^a	73.17±14.34	137.78±35.29^a	54.89±6.48	47.73±4.29^a
P值		0.577	0.026	0.575	0.000	0.138	0.000

组　别	例数	pH		PaO₂/FiO₂(mmHg)		PaCO₂(mmHg)
组　别	例数	入组时	72 h	入组时	72 h	入组时	72 h
观察组	17	7.23±0.02	7.44±0.04^a	72.24±16.32	181.47±31.29^a	55.41±5.35	43.56±4.67^a
对照组	13	7.26±0.02	7.35±0.03^a	73.17±14.34	137.78±35.29^a	54.89±6.48	47.73±4.29^a
P值		0.577	0.026	0.575	0.000	0.138	0.000

组　别	例数	SVI(ml/m²)		ELWI(ml/kg)		PVPI
组　别	例数	入组时	72 h	入组时	72 h	入组时	72 h
观察组	17	31.17±4.07	45.67±5.39^a	14.67±3.35	7.37±2.14^a	6.27±1.05	4.15±1.21^a
对照组	13	30.45±5.34	40.37±4.13^a	13.45±3.14	10.56±3.27^a	6.17±1.13	4.74±1.15^a
P值		0.324	0.035	0.248	0.000	0.618	0.003

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