摘要
目的 :探讨、评价肺保护性机械通气策略治疗 2 8例急性呼吸窘迫综合征 (ARDS)患儿时对避免与机械通气相关性肺损伤所起的作用。 方法 :对 2 8例先天性心脏病术后单纯并发 ARDS患儿采用 1高呼吸频率 ;2低潮气量 ;3限制气道峰压 ;4早期使用高呼吸末正压等通气模式 ,并在血液动力学监测下适当允许高碳酸血症。 结果 :与以往病例的治疗结果比 ,全组患者并发症低 ,无死亡。住院天数减少。 结论 :本组患儿治疗结果较好 ,作者认为要更新对 ARDS病理改变的认识 ,使用有针对性的肺保护性通气策略 ,避免与机械通气相关性肺的再损伤有关。
Objective:To sum up the clinical data of pediatric patients with acute respiratory distress syndrome(ARDS) in order to appreciate the high risk factors and assume an new strategy in mechanical ventilation,preventing the injury of the lung. Methods:We studied 28 paediatric patients with pure ARDS after open heart surgery.The manoeuvers in mechanical ventilation were as follow:①High respiratory frequency.②Low tidal volume.③Low peak inspiratory pressure.④Using PEEP in the early period in order to avoid lung damages from high concentration of oxygen and large tidal volume. Results:There were 2 cases (2/28) of barotrauma and 4 casese (4/28) with positive sputum culture. Conclusion:We consider that the conventional strategy in mechanical ventilation is not rational,it aggravates the lung damages and leads to failure of the treatment.The latter understanding of pathological changes of the lung and the new mechanical strategy contribute to the decreases of postoperative complications and mortality rate.
出处
《中国循环杂志》
CSCD
北大核心
2000年第3期172-173,共2页
Chinese Circulation Journal
