Effects of SI and PCV on respiratory mechanics, early central drive and hemodynamics in patients with ARDS

Mingxia Ji; Xiaofei Hong; Mengyan Chen; Tiejiang Chen; Yi'An Jia; Jinjiang Zhu; Xionglin Wu; Xiaoying Huang; Ning Zhang

doi:10.3892/etm.2019.7218

Effects of SI and PCV on respiratory mechanics, early central drive and hemodynamics in patients with ARDS

Exp Ther Med. 2019 Apr;17(4):2708-2714. doi: 10.3892/etm.2019.7218. Epub 2019 Jan 30.

Authors

Mingxia Ji¹, Xiaofei Hong², Mengyan Chen¹, Tiejiang Chen¹, Yi'An Jia¹, Jinjiang Zhu¹, Xionglin Wu¹, Xiaoying Huang¹, Ning Zhang³

Affiliations

¹ Department of Emergency, Yiwu Central Hospital, Yiwu, Zhejiang 320000, P.R. China.
² Department of Science and Education, Yiwu Central Hospital, Yiwu, Zhejiang 320000, P.R. China.
³ Department of ICU, Lishui People's Hospital, Lishui, Zhejiang 323000, P.R. China.

Abstract

Effects of sustained inflation (SI) and pressure- controlled ventilation (PCV) on respiratory mechanics, early central drive, and hemodynamics in patients with acute respiratory distress syndrome (ARDS) were investigated and compared. A retrospective analysis of 26 patients with ARDS, who were admitted to the Yiwu Central Hospital from March 2015 to March 2016, was performed. According to the ventilation method adopted by the patients with ARDS, 13 patients who received SI treatment were included in the SI group and 13 patients who received PCV treatment were included in the PCV group. The condition of central drive of the patients in the two groups was recorded and calculated continuously before and after recruitment maneuver (RM), the changes of each indicator of the respiratory function and hemodynamics were recorded and calculated before and after RM at 1, 10, 20 and 30 min. The differences were not statistically significant when comparing PIP, Pplate and Crs in patients in the SI group and the PCV group before RM with those after RM at 1, 10, 20 and 30 min (P>0.05), the differences were not statistically significant when comparing heart rate and mean arterial pressure in patients in the SI group and the PCV group before RM with those after RM at 1, 10, 20 and 30 min (P>0.05). Ηowever, central venous pressure in patients in the SI group after RM at 10 and 20 min was significantly higher than that in the PCV group, and the differences were statistically significant (P<0.05). VT/RMS, VE/RMS and ΔPdi/RMS in the SI group and the PCV group after RM were significantly higher than those before RM, and the differences were statistically significant (P<0.05). There was little difference in the effect between SI and PCV on respiratory mechanics, early central drive and hemodynamics in patients with ARDS, and both mechanical ventilation methods enhanced the effect of central-mechanical-ventilation coupling after RM. Therefore, the two mechanical ventilation methods, SI and PCV, were equally available for patients with ARDS.

Keywords: acute respiratory distress syndrome; early central drive; hemodynamics; pressure-controlled ventilation; respiratory mechanics; sustained inflation.