Effects and Efficacy Evaluation of Modified Prone Ventilation Combined with Bronchoscopic Alveolar Lavage on Respiratory Mechanics and Hemodynamics in Children with ARDS

Yao HOU; Nan KONG; Yuqin WU; Lin WANG; Ting WANG

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Yao HOU, Nan KONG, Yuqin WU, Lin WANG, Ting WANG. Effects and Efficacy Evaluation of Modified Prone Ventilation Combined with Bronchoscopic Alveolar Lavage on Respiratory Mechanics and Hemodynamics in Children with ARDS[J]. Journal of Kunming Medical University.

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Effects and Efficacy Evaluation of Modified Prone Ventilation Combined with Bronchoscopic Alveolar Lavage on Respiratory Mechanics and Hemodynamics in Children with ARDS

Emergency Department，Kunming Children's Hospital，Kunming Yunnan 650228 ，China

Received Date: 2024-07-19

Abstract

Abstract

Objective To explore the effects of modified prone ventilation combined with bronchoscopic alveolar lavage on respiratory mechanics and hemodynamics in children with Acute Respiratory Distress Syndrome （ARDS）, as well as to evaluate the clinical treatment efficacy. Methods A total of 96 ARDS children receiving mechanical ventilation treatment in the emergency intensive care unit of Kunming Children's Hospital from January 2021 to December 2023 were selected and randomly assigned into three groups: Group A （prone ventilation group, n = 32 ）, Group B （modified prone ventilation group, n = 32）, and Group C （modified prone ventilation combined with bronchoscopic alveolar lavage group, n = 32）. The changes in the following parameters before and after treatment among the three groups were compared: oxygenation indicators: arterial oxygen partial pressure （PaO₂）, arterial oxygenation index （PaO2/FiO₂）; respiratory mechanics indicators: lung compliance, mean airway pressure, plateau airway pressure, and total airway resistance; hemodynamic indicators: cardiac output, cardiac index, systemic vascular resistance index, and mean arterial pressure; clinical efficacy indicators time to disappearance of rales, mechanical ventilation duration, and length of hospital stay; and incidence of complications: arrhythmia, airway obstruction, pressure injuries, total incidence of catheter dislodgment, and gastric content reflux. Results The oxygenation indicators in Group C after treatment were superior to those in Groups A and B （P < 0.05）. The respiratory mechanics indicators in Group C after treatment were also better than those in Groups A and B （P < 0.05）. In terms of hemodynamics, there were no statistically significant differences in cardiac output, cardiac index, and mean arterial pressure among Groups A, B, and C after treatment （P > 0.05）. However, the SVRI in Group C was better than that in Groups A and B （P < 0.05）. Curative effect for Group C were also better than those for Groups A and B （P < 0.05）.The incidence of complications in Group C showed no significant difference compared to Groups A and B （P > 0.05）. Conclusion The modified prone ventilation combined with bronchoscopic alveolar lavage treatment scheme demonstrates better therapeutic effects compared to traditional treatment methods, significantly improving oxygenation and respiratory mechanics indicators as well as the systemic vascular resistance index in children, and is worthy of clinical promotion.
- Modified prone ventilation,
- Bronchoscopic alveolar lavage,
- ARDS,
- Respiratory mechanics,
- Hemodynamics

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References(16)

References

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