Effects of Dead Space Fraction on Prone Position Ventilation in ARDS Patients

Yan Yue Xin; Xu Mian; Yang De Xing; Liu Ya Ming; Zhou Feng Gao; Xu Cheng; Liu Rong

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Yan Yue Xin , Xu Mian , Yang De Xing , Liu Ya Ming , Zhou Feng Gao , Xu Cheng , Liu Rong . Effects of Dead Space Fraction on Prone Position Ventilation in ARDS Patients[J]. Journal of Kunming Medical University, 2017, 38(07): 64-68.

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Yan Yue Xin , Xu Mian , Yang De Xing , Liu Ya Ming , Zhou Feng Gao , Xu Cheng , Liu Rong . Effects of Dead Space Fraction on Prone Position Ventilation in ARDS Patients[J]. Journal of Kunming Medical University, 2017, 38(07): 64-68.

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Effects of Dead Space Fraction on Prone Position Ventilation in ARDS Patients

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基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2014FZ007);

Received Date: 2017-04-10

Abstract

Abstract

Objective To evaluate the effects of dead space fraction (VD/VT) on prone position ventilation (PPV) in patients with severe acute respiratory distress syndrome (ARDS) . Methods A total of 30 patients with severe ARDS (PaO2/FiO2< 100 mm H) g were enrolled in this study and were divided into pulmonary insult ARDS group (ARDSp) and extrapulmonary insult ARDS group (ARDSexp) according to different etiological factors. PaO2/FiO2 and VD/VT were recorded in supine position and prone position at 2 h, 4 h, 6 h, 8 h and 10 h after ventilation. Results VD/VT decreased and PaO2/FiO2 increased with PPV. PaO2/FiO2 and VD/VT showed significant difference at different time points (P < 0.001) , with the biggest change of VD/VT at PPV 4 h and the best transformation of PaO2/FiO2 (increase of PaO2/FiO2>20 mm H) g after PPV 6 h. There was a positive correlation between VD/VT and PaO2/FiO2 by Pearson correlation analysis (t=0.67, P < 0.001) . In ARDSp group, there was no significant change of PaO2/FiO2 and VD/VT between supine position and PPV 2 h. At PPV 4 h, PaO2/FiO2 significantly increased (t=2.37, P=0.03) and VD/VT significantly decreased (t =5.26, P=0.001) . No significant difference was found in PaO2/FiO2 and VD/VT at PPV 4 h to PPV 6 h. In ARDSexp group, PaO2/FiO2 significantly increased (t=4.65, P=0.04) and VD/VT significantly decreased (t=3.56, P=0.009) at PPV 2h. There was no significant change from PPV 2 h to PPV 4 h. PaO2/FiO2 and VD/VT remained at the same level at PPV 6 h. Conclusion VD/VT can be used as an effective index to evaluate the efficacy of PPV in patients with ARDS and is more sensitive than PaO2/FiO2, so it can be used to guide the treatment of patients with pulmonary and extrapulmonary ARDS.
- Dead space fraction,
- Pulmonary and extrapulmonary acute respiratory distress syndrome,
- Prone position ventilation,
- Efficacy

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References(20)

References

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