Yin Jiangtao, Pan Xin, Jia Jue, Sun Shuangshuang, Wan Bing
Department of Intensive Care Unit, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, P.R. China.
Emergency Department, Zhenjiang Emergency Center, Zhenjiang, Jiangsu 212001, P.R. China.
Exp Ther Med. 2019 Mar;17(3):1952-1958. doi: 10.3892/etm.2019.7157. Epub 2019 Jan 7.
Mechanical ventilation support is commonly required in abdominal compartment syndrome (ACS). In the present study, pressure-regulated volume control ventilation (PRVCV) was compared to pressure control ventilation (PCV) in patients with ACS. The prospective study included 40 patients with ACS who were randomized into the PCV or PRVCV groups and subjected to the different modes of ventilation. After 6 h of ventilation, arterial blood gas, respiratory mechanics and hemodynamics parameters, as well as the intra-abdominal pressure (IAP) and Sequential Organ Failure Assessment (SOFA) scores were calculated. Compared to the PCV mode, mechanical ventilation with PRVCV lead to a significant decrease in the partial pressure of carbon dioxide, the peak inspiratory pressure, the mean inspiratory pressure, the central venous pressure, the heart rate and the extravascular lung water index. In addition, a marked improvement in pH, partial pressure of oxygen, oxygenation index and pulmonary static compliance was noted. However, no significant differences in airway resistance, mean arterial pressure, or IAP and SOFA scores were obtained. In conclusion, the PRVCV mode is better than the PCV mode in ventilation patients with ACS, and should therefore be used as a lung protective strategy. The present study was registered at Chictr.org (no. ChiCTR1800016869).
腹部腔室综合征(ACS)通常需要机械通气支持。在本研究中,对ACS患者的压力调节容量控制通气(PRVCV)与压力控制通气(PCV)进行了比较。这项前瞻性研究纳入了40例ACS患者,他们被随机分为PCV组或PRVCV组,并接受不同的通气模式。通气6小时后,计算动脉血气、呼吸力学和血流动力学参数,以及腹内压(IAP)和序贯器官衰竭评估(SOFA)评分。与PCV模式相比,PRVCV机械通气导致二氧化碳分压、吸气峰压、平均吸气压力、中心静脉压、心率和血管外肺水指数显著降低。此外,pH值、氧分压、氧合指数和肺静态顺应性有明显改善。然而,气道阻力、平均动脉压、IAP和SOFA评分没有显著差异。总之,PRVCV模式在ACS通气患者中优于PCV模式,因此应作为一种肺保护策略使用。本研究已在Chictr.org注册(编号:ChiCTR1800016869)。