Clinical study of sustained inflation on patients with acute respiratory distress syndrome

Objective

To evaluate the therapeutic effects of sustained inflation (SI) combined with lung protective strategy in patients with acute respiratory distress syndrome (ARDS).

Design

Prospective study.

Setting

Medical intensive care unit, university hospital.

Patients

Twenty mechanically ventilated ARDS patients.

Interventions

SI (30 cmH₂O, 20 s) was combined with lung protective strategy in 20 ARDS patients. Hemodynamics, pulmonary mechanics and gas exchange were monitored continuously.

Measurements and results

SI was well tolerated by every patient. Four patients were lack of beneficial effects. Arterial oxygen tension and saturation, mixed venous oxygen tension and saturation increased after SI, while venous admixture decreased (P < 0.05). Dynamic pulmonary compliance and lung volume improved markedly. The effects were maintained in 16 patients for 4 hours. Mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, mean pulmonary arterial pressure, pulmonary vascular resistance index and right ventricular stroke work index significantly increased during the 20 s inflation (P < 0.05), but reversed rapidly after the inflation was terminated.

Conclusions

Using with lung protective strategy, SI is able to improve pulmonary compliance, lung volume and oxygenation. It is a safe and valid lung recruitment maneuver.