[Comparison of the effects of BiPAP ventilation combined with lung recruitment maneuvers and low tidal volume A/C ventilation in patients with acute respiratory distress syndrome].
OBJECTIVE
To compare the effects of BiPAP ventilation combined with lung recruitment maneuvers (LRM) with low tidal volume A/C ventilation in patients with acute respiratory distress syndrome (ARDS).


METHODS
A prospective, randomized comparison of BiPAP mechanical ventilation combined with lung recruitment maneuvers (test group) with low tidal volume A/C ventilation (control group) was conducted in 28 patients with ARDS. FiO2/PaO2 ratio, respiratory system compliance (Cs), central venous pressure (CVP), duration of ventilation support were recorded at 0 h, 48 h and 72 h separately. The ventilation associated lung injury and mortality at 28 d were also recorded.


RESULTS
The FiO2/PaO2 ratio were (298+/-16) and (309+/-16) cm H2O, Cs were (38.4+/-2.2) and (42.0+/-1.3) ml/cm H2O, CVP were (13.8+/-0.8) and (11.6+/-0.7) cm H2O in the test group at 48 h and 72 h separately. In the control group, FiO2/PaO2 ratio were (212+/-12) and (246+/-17) cm H2O, Cs were (29.5+/-1.3) and (29.0+/-1.0) ml/cm H2O, CVP were 18.6+/-1.1 and (16.8+/-1.0) cm H2O. The results were better in the test group as compared with the control group (t=10.03-29.68, all P<0.01). The duration of ventilation support in the test group was shorter than the control group [(14+/-3) d vs (19+/-3) d, t=4.80, P<0.01]. The mortality in 28 d and ventilation associated lung injury were similar in the two groups.


CONCLUSIONS
The results show that combination of LRM with BiPAP mode ventilation, as compared with the control group, contributes to improved FiO2/PaO2 ratio, pulmonary compliance, stable hemodynamic and shorter duration of ventilation support in patients with ARDS.
Wang
Xiao-zhi
XZ
Department of Respirology & Intensive Care Unit, Binzhou Medical College, Shandong Province 256603, China.
Lü
Chang-jun
CJ
Gao
Fu-quan
FQ
Li
Xiao-hong
XH
Hao
Dong
D
Ning
Fang-yu
FY
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D015656:Respiratory Mechanics; D013990:Tidal Volume; D055815:Young Adult