Effect Of Bronchoalveolar Lavage On The Patients Accepted Invasive Mechanical Ventilation With Severe Community-acquired Pneumonia

Objective: Through the analysis the physiology and clinical indicatorsofthepatientswith SCAP who accepted invasive mechanical ventilationandbronchoscope, Toevaluatethe effect ofclinical applicationto thepatientswith SCAP after being disposedbybronchoalveolar; To explore the security of bronchoscope for thepatients with SCAP.Methods:Consulting caseswho stayed in intensive care unit of shaanxi provincepeople’s hospital to accept the adjuvant treatment of invasive mechanical ventilation withthe infection of SCAPon2011,01to2013,01. The74cases were selected as the researchobject.The40cases were classified as the observation group, these people were given thebronchoscope alveolar lavage in24hoursin intensive care unit;40cases were classifiedas the control group: all the treatment were same asthe observation group, but nothebronchoscope alveolar lavage treatment,two groups were all given routine anti-infection,eliminating phlegm, nutritional support, comprehensive treatment at the same times.Priortreatment was set as time when patients were initially received mechanicalventilation,Posttreatment was set as time when patientsreceived treatment in ICU.Allkinds of index before and after treatment of the patient such as mechanical ventilationparameters, respiratory physiology index, clinical indicatorsetc,all of that werecollected.Comparing all the changes of the indicators of the twogroups before and aftertreatment. The index of prior treatment were tested by abalance testing, the possibleimbalance indicators were deposed by linear regressionmethod.To investigate the effecton the indicators after treatment.Results:The results of the study48hours after the treatment, comparing the index ofobservation group before and after treatment, oxygenation index, blood PH and tidal volume increased, breathing rate, body temperature, PS, PEEP, PCO2, white blood cellcount and PCT index decreased, the changes had statistically significant (P <0.05).Theindicators of observation group and control group before treatment tested by balancetesting, the distribution of indicators ofprevalence such as cerebral vascular disease, PH,PCO2, PCT and oxygenation index,were unbalanced.The results,after general linearregression analysis method was applied to control eachimbalance of index obtained48hours after treatment, show that:oxygenation index, the observation group increasedmore22.437than the control group; PH value, increased0.153;breathing rate, fell2.027times/min;body temperature, observation group were0.332℃lower than the controlgroup;PS fell1.648cmH2O.PEEP fell1.799cmH2O;PCO2, observation group7.927mmHg lower than the control group;white cell count fell2.192x109/L;PCT decline0.489ng/ml;heating time,1.491days less than the control group;mechanical ventilationtime,1.882days less than the control group;ICU time,1.491days fell than the controlgroup, all the result had statistical significance (P <0.05).During the ICU, no death werefound in observation group,4patients died in control group,the others change for better.Conclusion:Patients with SCAP who accepted invasive ventilation by the tone ofpipe line and bronchoalveolar lavage based on the treatment of conventionalanti infection.the various parameters of mechanical ventilation, theindicators ofrespiratory physiology and clinical would be improved in the short term.And these were propitious to control the later pulmonary infection.At the sametime, shorten the time of mechanical ventilation and ICU.there were no obviouscomplications.So this was a relatively safe clinical technology.