Through the electrical impedance tomography technology(EIT) to observe the position of the effects of mechanical ventilation in patients with ARDS lung ventilation
Wang Yugang, Wang Hongwei, Wang Shuangshuang, Yang Weiran, Ye Gang
2017, 38(6):
919-924.
doi:10.3969/j.issn.1006-7795.2017.06.027
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Objective To use electrical impedance tomography technology(EIT) to observe acute respiratory distress syndrome (ARDS) patients with mechanical ventilation, in the distribution of gas in the lungs of patients with different position, and to observe the oxygen partial pressure, oxygenation index, changes of the tidal volume.Methods The prospective randomized study method will be used, the patients with ARDS in the Emergency Intensive Care Unit,Beijing Luhe Hospital,Capital Medical University in January 2015 to June 2017 were tested with lines of mechanical ventilation as the research objects, and vis application of random grouping method, the tests were divided into trial group and control group. Experimental group will be set to normal position effectively to raise 30 degrees, on the basis of daily 8 hours continuously to patients with 90 degrees of sitting position. The control group was set up 30 degrees continuously for the position. The two groups of patients were compared, position effectively maintains 72, 96, 120 hours, respectively which were collected by electrical impedance imaging region of interest (ROI) values of two groups of patients, patients which were collected through breathing machine tidal volume, through the blood gas analysis to collect oxygen partial pressure, oxygenation index parameters, such as breathing machine and use time and care in the hospital. Results Finally, a total of 60 patients were included in the analysis of 27 cases of test group and control group 33 cases. Two groups of patients with g ender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores and lead to the causes of ARDS was no statistically significant difference. Compared with the control group, experimental group patients in position effectively maintain 96 hours and 120 hours after PaO2 and oxygenation index was significantly higher than the control group, differences were statistically significant (P<0.05), at the same time, through the observation of EIT technology experimental group patients gravity ROI3 values depend on the area for 96 hours and 120 hours, ROI4 value was significantly higher than the control group (P<0.05). Patients in the experimental group were significantly lower in ventilator use time and in the hospital than in the control group (P<0.05);the experimental group compared with the control group in position effectively maintain 96 hours and 120 hours after, tidal volume no significant change (P>0.05). Position effectively maintain 72 hours, the experimental group compared with the control group patients of oxygen partial pressure, oxygenation index, tidal volume,the difference were statistically significant (P>0.05).Conclusion For patients with ARDS line during invasive ventilation, daily continuously to 90 degrees patients keep sitting more than 8 hours, after 96 hours, can effectively improve the gravity depend on the changes of pulmonary ventilation, effectively improve the patient's oxygen partial pressure and oxygenation index, promote patients of pulmonary rehabilitation, promote patients successfully weaning tube drawing at an early date.
