Li Bo, Li Duoling, Huang Wei, Che Yuanyuan
Pediatric Intensive Care Unit of Maternity and Child Health Care of Zaozhuang, Zaozhuang, China.
Pediatric Intensive Care Unit of Tongxu People's Hospital, Kaifeng, China.
Transl Pediatr. 2020 Dec;9(6):795-801. doi: 10.21037/tp-20-383.
Acute respiratory distress syndrome (ARDS) is a common pediatric disease, with an increasing mortality rate in recent years. This study aims to explore the effects of lung recruitment on blood gas indexes, hemodynamics, lung compliance, and rehabilitation index in children with ARDS.
Seventy children with ARDS admitted to our hospital from December 2017 to December 2018 were selected as the study subjects, and were divided into a study group (35 cases, treated with lung recruitment strategy) and a control group (35 cases, treated with routine therapy). The changes of blood gas indexes, such as partial pressure of oxygen (PO), partial pressure of carbon dioxide (PCO), and partial pressure of oxygen/fraction of inspired oxygen (PO/FiO) levels, as well as hemodynamic indexes, including cardiac output (CO), heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), were compared before and after treatment in the two groups.
Results showed that the difference in blood gas indexes between the two groups was statistically significant after treatment (P<0.05), and that the levels of PaO, PaCO, pondus Hydrogenii (pH), and PO/FiO in the study group were all higher compared to the control group (P<0.05). The hemodynamic indexes showed that CO was significantly different between the two groups (P<0.05), but HR, MAP, and CVP were not (P>0.05). The lung compliance values of the two groups continued to increase at different time points after treatment (P<0.05), and the lung compliance of the study group was higher than that of the control group immediately after recruitment, as well as at 10 and 60 min of lung recruitment (P<0.05). In addition, the ventilator use, ICU stay, and hospital stay times of the study group were shorter than those in the control group (P<0.05), and the mortality rate of the study group was lower than that of the control group (P>0.05).
The lung recruitment strategy has a significant therapeutic effect on children with ARDS. It can effectively improve blood and gas function and lung compliance, and has a positive effect on the hemodynamic stability of children with ARDS.
急性呼吸窘迫综合征（ARDS）是一种常见的儿科疾病，近年来死亡率不断上升。本研究旨在探讨肺复张对ARDS患儿血气指标、血流动力学、肺顺应性及康复指标的影响。
选取2017年12月至2018年12月我院收治的70例ARDS患儿作为研究对象，分为研究组（35例，采用肺复张策略治疗）和对照组（35例，采用常规治疗）。比较两组治疗前后血气指标变化，如氧分压（PO）、二氧化碳分压（PCO）、氧分压/吸入氧分数（PO/FiO）水平，以及血流动力学指标，包括心输出量（CO）、心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）。
结果显示，治疗后两组血气指标差异有统计学意义（P<0.05），研究组的PaO、PaCO、酸碱度（pH）和PO/FiO水平均高于对照组（P<0.05）。血流动力学指标显示，两组间CO差异有统计学意义（P<0.05），但HR、MAP和CVP差异无统计学意义（P>0.05）。两组治疗后不同时间点肺顺应性值持续升高（P<0.05），研究组在复张即刻以及复张后10分钟和60分钟时的肺顺应性高于对照组（P<0.05）。此外，研究组的呼吸机使用时间、ICU住院时间和住院时间均短于对照组（P<0.05），研究组的死亡率低于对照组（P>0.05）。
肺复张策略对ARDS患儿有显著治疗效果。它能有效改善血气功能和肺顺应性，对ARDS患儿的血流动力学稳定有积极作用。
