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Of mechanical ventilation in adult respiratory distress syndrome patients by

Paper Keywords: adult respiratory distress syndrome; mechanical ventilation; care Abstract: 38 cases of lung protective mechanical ventilation in patients with the guardianship role and significance. By monitoring 38 cases of adult respiratory distress syndrome (ARDS) patients demonstrate the role of mechanical ventilation, ventilation regulation, for cure in patients with ARDS has an important role and significance, can reduce complications. Of ARDS patients, lung protective mechanical ventilation care is essential. Adult respiratory distress syndrome (ARDS) is a type of acute respiratory failure, due to various reasons (except for left heart failure) by pulmonary gas exchange within the organization and function of vascular disorders, lung water content increase, reduce lung compliance, alveolar atrophy, ventilation, blood flow imbalance to severe hypoxemia and respiratory distress for the typical symptoms extremely difficult [1]. ARDS rapid onset, rapid development, high mortality, early mechanical ventilation is an important means of treatment of ARDS. Mechanical ventilation in ARDS treated with lung protective ventilation strategy, the main measures: application of positive end expiratory pressure (PEEP) to increase end-expiratory lung volume, collapse of small airways and alveoli open and reduce alveolar edema, thus improving the dispersion of alveolar function and blood flow ratio of ventilation to reduce the pulmonary shunt, to improve oxygenation and lung compliance purposes. Small tidal volume to prevent alveolar hyperinflation, permissive hypercapnia. Our department from January 2001 to December 2008,[link widoczny dla zalogowanych], 8 years were admitted 38 patients with ARDS, mechanical ventilation with lung protective strategies, through rigorous monitoring and timely adjust the parameters of mechanical ventilation, received good therapeutic effect, are as follows. 1 clinical data 38 patients,[link widoczny dla zalogowanych], male 10 cases and 28 girls, aged 15 to 72 years, mean 42 years, the primary disease: acute organophosphorus pesticide poisoning in 20 cases, Other poisoning in 3 cases, 4 cases of drowning, severe pneumonia in 6 cases, 5 cases of diabetic ketoacidosis. ARDS diagnosis of respiratory failure in 1999 National Symposium on the discussion and adoption of the standard [1]. 2 methods lung protective ventilation strategy, the patient once the diagnosis of ARDS, while in the treatment of primary disease, as soon as intubation, mechanical ventilation given. As CPAP + PEEP ventilation or SIMV + PEEP + PSV; tidal volume 8ml/kg, respiratory rate 12 to 20 times / min, PEEP4cm-10 cm H2O, mechanical ventilation time was 3 to 18 days, an average of 8 days, using multi-functional 24h monitoring vital signs monitor, dynamic observation of blood pressure, oxygen saturation, heart rate and rhythm changes, daily monitoring of central venous pressure 1 or 2 times, arterial blood gas analysis 1, while good airway management, monitoring the functioning of respirator the timely processing of all kinds of alarm. 3 care 3.1 under normal circumstances the application of respiratory care unit, to observe the patient's consciousness, mental status, depth of intubation, chest rise and fall of the situation and both lungs breathing, pay attention to changes in the airway,[link widoczny dla zalogowanych], timely suction, suction before the first inhalation of high concentrations of oxygen. One-time use of closed suction tube, suction time, every time less than 10s. 3.2 hemodynamic monitoring the use of mechanical ventilation, in particular, is the application of PEEP, can cause decreased cardiac output, leading to low blood pressure, change of consciousness, decreased urine output, especially in the PEEP greater than 10 cm H2O, so to monitor the heart rate, blood pressure, urine output, peripheral circulation and perception level. PEEP should be from 3 cm using H2O ~ 5 cm H2O, PEEP before and after each adjustment to monitor blood pressure changes, hemodynamic changes found in this group, 4 cases showed changes in consciousness, heart rate, decreased urine output, blood pressure, slow blood flow ,[link widoczny dla zalogowanych], capillary filling,[link widoczny dla zalogowanych], the PEEP to 5 cm H2O, increased infusion volume, the use of dobutamine gradually stable.
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