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Evaluation of the Efficacy of Pressure-Regulated Volume-Control Ventilation Mode in Mechanical Ventilation Therapy of ARDS Patients |
JIA Shengnan, JIANG Donghui, WANG lvguo, et al |
The Affiliated Hospital of Jiangnan University, Jiangsu Wuxi 214100, China |
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Abstract Objective: To explore the application effect of pressure-regulated volume control in the treatment of acute respiratory distress syndrome.Methods: From February 2019 to February 2022, 120 patients with moderate-to-severe acute respiratory distress syndrome in the Affiliated Hospital of Jiangnan University were retrospectively selected and divided into two groups according to the treatment method: pressure-regulated volume-controlled ventilation group (observation group) and synchronous intermittent command ventilation group (control group), 56 and 64 patients respectively.Respiratory mechanics and blood gas parameters after 24 hours of mechanical ventilation were statistically analysed and the overall clinical outcome, duration of oxygen therapy, duration of mechanical ventilation, length of hospital stay, complications and prognosis at 28 days were compared between the two groups.Results: 24h after treatment, the mean arterial pressure (MAP)(12.45 vs 14.56 KPa), positive end-expiratory pressure (PEEP)(9.42vs12.02 cmH2O), peak airway pressure (PIP)(25.42vs28.56 cmH2O) and arterial carbon dioxide partial pressure (PaCO2) (38.41vs47.47 mmHg)in the observation group were significantly lower than those in the control group (P<0.05), the arterial partial pressure of oxygen (PaO2)(69.90vs65.00mmHg)was higher than that of the control group (P<0.05). 28days after treatment, the total effective rate of patients in the observation group (92.85%) was significantly higher than that in the control group (78.13%) (χ2=5.084, P<0.05). Compared to the control group,in the observation group the oxygen therapy time(158.08vs170.61h)(P<0.05), the mechanical ventilation time(87.40vs125.30h)(P<0.05), and the hospitalization time(15.51vs24.11d)(P<0.05)were shorter.The incidence of ventilator-related lung injury in the observation group (7.14%) was significantly lower than that in the control group (39.06%) (P<0.05).Conclusion: Compared to the synchronised intermittent command ventilation group, pressure-regulated volume-controlled ventilation in the treatment of acute respiratory distress syndrome significantly improved patients' respiratory mechanics and blood gas indices, improved clinical outcomes, shortened oxygen therapy time, duration of mechanical ventilation and hospital stay, reduced the incidence of ventilator-associated lung injury and improved patients' 28-day prognosis.
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