A Clinical Study Of The Evaluation Of The EELV On The Effect Of PEEP On The Lung Recruitment Of ARDS

Objective:This study is mainly to understand the effect of PEEP on EELV and EELV was applied to assess the significance of lung recruitment at bedside,as well as the responsiveness of different degrees of ARDS to PEEP.Method:20 patients were collected according to the Berlin standard and classified into mild and moderate groups.,The ventilator was used to determine EELV uniformly.Setting to volume control ventilation,make the patient in a supine position,use the sedatives,analgesics and muscle relaxants to eliminate the spontaneous breathing.Choosing to different levels of PEEP,15 cmH20 and 5 cmH20.After a balanced ventilation,to measure and record EELV,the change of Vpeep after lung recruitment,blood gas analysis,the changes of respiratory mechanics parameters,and then according to the formula to calculate and analysis the corresponding values.Results:The EELV at two PEEP levels were observed in both mild and moderate groups respectively(28.80±3.80 VS 25.10=4.23,18.80±3.52 VS 16.50±3.31),and the difference was statistically significant(P<0.001).The results of strain that were calculated at different PEEP levels were respectively(1.26q0.56 VS 0.72±10.55,1.22±0.36 VS 0.75±0.35),there were statistically significant(P<0.05)?Compliance was positively correlated with the severity of the disease,as the severity of the disease aggravates the compliance,the difference is statistically significant(P<0.05),The compliance of the two groups(74.32±13.70 VS 53.16±14.50,48.16±8.72 VS 34.07±5.86)decreased with the decrease of PEEP,and the differences between the two groups were statistically?The PaO2/FiO2 increased with the increase of PEEP,The Pa02/Fi02 of the two groups at 15cmH2O and 5cmH20 respectively were(290.60±37.01 VS 161.50±36.66,226.10±10.59 VS 145.00±20.92),The differences were statistically significant(P<0.05),but the correlation of the Pa02/Fi02 and EELV founded that mild group and moderate group patients at high PEEP both significantly(P<0.05),while low PEEP was irrelevant?The measured value of FRC significantly related with the expected value of FRC,(P<0.05)?According to different causes can be divided into pulmonary group and the extra-pulmonary group,compared EELV,strain under different PEEP level differences of two groups,there's no statistical significance(P>0.05)?Compliance is characterized by pulmonary group(53.17± 14.50 VS 34.07±5.86)is better than that of the extra-pulmonary group(74.32± 13.70 VS 48.17±8.72),and the difference is statistically significant(P<0.05).Conclusion:The combination of EELV and strain can be used to evaluate PEEP-induced recruitment.