Efficacy Of Lung Recruitment Maneuver Combined With Protective Ventilation In The Treatment Of Acute Respiratory Distress Syndrome And Its Effect On Lung Compliance And Inflammatory Mediators

Objective: To investigate the efficacy of lung recruitment combined with protective ventilation in the treatment of acute respiratory distress syndrome(ARDS)and its effects on lung compliance and inflammatory mediators.Method: Select clinical data of 92 patients with ARDS admitted to our hospital from June 2019 to December 2021 were selected for a prospective randomized controlled study,they were divided into routine group(receiving protective mechanical ventilation therapy,45 cases)and intervention group(combined with intermittent pulmonary reexpansion therapy on the basis of protective mechanical ventilation,47 cases)according to random number grouping table.The therapeutic effects of ARDS before treatment and 24 h after treatment were compared between the two groups.Including blood oxygen partial pressure(Pa O2),carbon dioxide partial pressure(Pa CO2),oxygenation index(Pa O2/Fi O2);The Static lung compliance(Cst)level was compared between the two groups before treatment and 24 h after treatment;Before treatment and 72 hours after treatment,the levels of C-reactive protein(CRP),Interleukin-6(IL-6),tumor necrosis factor(TNF-a),compared the prognosis-related indicators of the two groups of patients,including mechanical ventilation time,artificial airway removal time,ICU hospitalization timeResult:(1)After lung protective ventilation strategy,oxygen partial pressure and oxygen index in both the conventional group and the intervention group were significantly improved,especially in the intervention group.Pa CO2 increased in both the conventional group and the intervention group,and the increase in the intervention group was slightly lower than that in the conventional group.(P < 0.05).(2)Before treatment,there was no statistical significance in Cst level between 2 groups(P > 0.05).After 24 h of treatment,Cst levels in both the conventional group and the intervention group were significantly improved compared with the basic state,and the effect in the intervention group was more obvious,with statistical significance(P < 0.05).(3)Before treatment,there was no statistical significance in the levels of CRP,IL-6 and TNF-a between 2 groups(P > 0.05).After treatment,the inflammatory indexes of the two groups were better than before treatment.The effect was better in the intervention group and the difference was statistically significant.(4)After treatment,lung reexpansion could shorten the mechanical ventilation time,ICU stay time and artificial airway removal time,and the difference between the two groups was statistically significant(P<0.05).Conclusion: Lung reexpansion combined with protective ventilation in the treatment of ARDS can correct hypoxemia,improve lung compliance,reduce the level of inflammatory mediators,shorten the treatment time of patients,and promote the recovery of patients.