Effects of inverse ratio ventilation combined with lung protective ventilation on pulmonary function in patients with severe burns for surgery

OBJECTIVE: To investigate the effects of inverse ratio ventilation combined with lung-protective ventilation on pulmonary function and inflammatory factors in severe burn patients undergoing surgery. Populations and Methods: Eighty patients with severe burns undergoing elective surgery were divided randomly into two groups: control (CG, n = 40) and experiment (EG, n = 40). The CG had conventional ventilation, whereas the EG were ventilated with tidal volume (TV) of 6-8 ml/kg, I (inspiration): E (expiration) of 2:1, and positive end-expiratory pressure (PEEP) 5 cm H2O. The following variables were evaluated before (T0), 1 h after start of surgery (T1) and after surgery (T2): oxygenation index (OI), partial pressure of carbon dioxide (PaCO2), TV, peak airway pressure (Ppeak), mean airway pressure (Pmean), PEEP, pulmonary dynamic compliance (Cdyn), alveolar-arterial difference of oxygen partial pressure D(A-a)O2, lactic acid (Lac), interleukin (IL)-6 and IL-10, and lung complications. Results: At T1 and T2 time points, the OI, Pmean and Cdyn were significantly greater in the EG than in the CG while the TV, Ppeak, D(A-a)O2, IL-6 and IL-10 were significantly smaller in the EG than in the CG. At the end of the surgery, the Lac was significantly smaller in the EG than in the CG (1.28 ± 0.19 vs. 1.40 ± 0.23 mmol/L). Twenty-four hours after the surgery, significantly more patients had hypoxemia (27.5 vs. 10.0%), increased expectoration (45.0 vs. 22.5%), increased lung texture or exudation (37.5 vs. 17.5%) in the CG than in the EG. Conclusions: Inverse ratio ventilation combined with lung-protective ventilation can reduce Ppeak, increase Pmean and Cdyn, improve the pulmonary oxygenation function, and decrease ILs in severe burn surgery patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

The Libyan journal of medicine - 15(2020), 1 vom: 19. Dez., Seite 1767276

Sprache:

Englisch

Beteiligte Personen:

Yang, Yan-Chao [VerfasserIn]
Huai, Qiao [VerfasserIn]
Cui, Shu-Zhen [VerfasserIn]
Cao, Xiao-Wei [VerfasserIn]
Gao, Bu-Lang [VerfasserIn]

Links:

Volltext

Themen:

Hypoxemia
Inflammatory factor
Journal Article
Pulmonary edema
Randomized Controlled Trial
Thermal injury
Ventilation–perfusion mismatch

Anmerkungen:

Date Completed 12.07.2021

Date Revised 12.07.2021

published: Print

Citation Status MEDLINE

doi:

10.1080/19932820.2020.1767276

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310238161