Han Guan-Jie, Li Jia-Qiong, Pan Cui-Gai, Sun Jing-Xi, Shi Zai-Xiang, Xu Ji-Yuan, Li Mao-Qin
Department of Intensive Care Unit, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu 221009, P.R. China.
Exp Ther Med. 2017 Sep;14(3):1941-1946. doi: 10.3892/etm.2017.4718. Epub 2017 Jul 6.
Airway pressure release ventilation (APRV) is a ventilator mode which has demonstrated potential benefits in acute respiratory distress syndrome (ARDS) patients. We therefore sought to compare relevant pulmonary data and safety outcomes of this mode to the conventional ventilation and sustained inflation. Canines admitted after intravenous injection of oleic acid requiring mechanical ventilation were randomly divided into 3 groups (n=6), namely conventional ventilation group, low tidal volume ventilation with recruitment group (LTV+SI) and APRV group. The changes of oxygenation, ventilation, airway pressure, inflammatory reaction and hemodynamics at the basic state were observed at 0, 1, 2 and 4 h during the experiment. The levels of PaO/FiO in APRV group were higher than LTV+SI group at 2 and 4 h (P<0.05). In APRV group, the PCO levels at 1, 2 and 4 h is much lower than LTV+SI group (P<0.05). Outcome variables showed no differences between APRV, LVT+SI and conventional mechanical ventilation for plateau airway pressure (24±1 vs. 29±3 vs. 25±4), mean arterial pressure (92.9±16.5 vs. 85.8±21.4 vs. 88.7±24.4), cardiac index (4.3±1.7 vs. 3.5±1.9 vs. 3.4±2.1), ERO (13.4±10.3 vs. 16.1±6.8 vs. 17.6±9.1), lac (2.5±1.7 vs. 3.1±1.6 vs. 3.9±1.9), tumor necrosis factor (TNF)-α (132±11 vs. 140±6 vs. 195±13) and matrix metalloproteinase (MMP)-9. For canines sustaining acute respiratory distress syndrome requiring mechanical ventilation, APRV can significantly improve oxygenation and keep hemodynamic stability compared with LTV+SI. The results of TNF-α and MMP-9 suggest that APRV could be as protective for ARDS as LTV with recruitment group.
气道压力释放通气（APRV）是一种通气模式，已在急性呼吸窘迫综合征（ARDS）患者中显示出潜在益处。因此，我们试图比较该模式与传统通气及持续膨肺的相关肺部数据和安全性结果。静脉注射油酸后因需要机械通气而入院的犬只被随机分为3组（每组n = 6），即传统通气组、小潮气量通气联合肺复张组（LTV+SI）和APRV组。在实验过程中的0、1、2和4小时观察基础状态下的氧合、通气、气道压力、炎症反应和血流动力学变化。APRV组在2小时和4小时时的PaO/FiO水平高于LTV+SI组（P<0.05）。在APRV组中，1、2和4小时时的PCO水平远低于LTV+SI组（P<0.05）。结果变量显示，APRV组、LVT+SI组和传统机械通气组在平台气道压力（24±1 vs. 29±3 vs. 25±4）、平均动脉压（92.9±16.5 vs. 85.8±21.4 vs. 88.7±24.4）、心脏指数（4.3±1.7 vs. 3.5±1.9 vs. 3.4±2.1）、ERO（13.4±10.3 vs. 16.1±6.8 vs. 17.6±9.1）、乳酸（2.5±1.7 vs. 3.1±1.6 vs. 3.9±1.9）、肿瘤坏死因子（TNF）-α（132±11 vs.
