Retrospective Analysis:Ventilator Therapy For Extraordinarily Severe Burned Patients With Severe Inhalation Injury

ObjectiveTo investigate and retrospectively analyze the therapeutic effect of SIMV model combined with neap volume and low PEEP protective mechanical ventilation on severely burned patients with severe inhalation injury by collecting the data of the above said patients in the ICU of our hospital.MethodsThe patients who met the diagnostic criteria of"1.being extraordinarily severely burned,2.with severe inhalation injury"were screened,among them,a total of21 patients were treated with SIMV model of protective mechanical ventilation.The treatment process was retrospectively studied,and blood gas analysis results before and after ventilator-assisted ventilation were statistically analyzed to make data analysis.The blood gas analysis was reviewed once within 12h after ventilation,and blood gas analysis was reviewed once every morning after ventilation,which was used as the basis for properly adjusting ventilator model parameters.Therefore,the data of blood gas analysis test sheet at 5 different time points was selected for statistics as follows:（1）1 time of blood gas analysis before ventilator assisted ventilation;（2）1 time of review of blood gas analysis within 12 hours after ventilation;（3）review of blood gas analysis in the mornings of the first three days after ventilation,a total of 3 times.The changes of oxygen partial pressure（PO₂）,carbon dioxide partial pressure（PCO₂）,oxygen saturation（SO₂）and lactic acid（Lac）were studied to understand the hypoxia degree and treatment effects before and after ventilation.Statistical Scheme:results were expressed by?x±s,using SPSS 22.0 software line t test for data analysis,P<0.05 was of value statistically while P<0.01 was of significant value.Results 1.Partial pressure oxygen（PO₂）changes:The results of the reexamination of PO₂ values in the four blood gas analyses after auxiliary ventilation were all P<0.01compared with those before ventilation,showing a significant statistical difference.Before ventilation the average oxygen partial pressure of the patients in this group was far lower than the normal while their PO₂ increased after treatment,and the average was higher than 80mmol/L.2.Partial pressure of carbon dioxide（PCO₂）changes:the average PCO₂ of the patients in this group was still within the normal range before ventilation,and the results of 4 blood gas analyses after ventilation were all P>0.05 compared with those before ventilation,showing no statistical difference.The PCO₂ level was roughly consistent with that before ventilation,suggesting no significant change in PCO₂ before and after ventilation.3.Blood oxygen saturation（SO₂）changes:the SO₂ of 4 blood gas analyses after ventilation were all P<0.01 compared with those before ventilation,showing a significant statistical difference.Before ventilation,the average SO₂ only maintained about 92%,and after treatment,the average mostly rose to 96%.4.Lactate（Lac）changes:after an effective simultaneous anti-shock treatment was given to the patients in this group,the analysis data showed that Lac changes appeared a downward trend,and there was a statistical difference between Lac and that of pre-ventilation within 12h and 1d after ventilation（P<0.05）,and it was a significant statistical difference between Lac and that of pre-ventilation（P<0.01）within 2d and 3d after ventilation.After 3-day treatment,the average value of blood lactic acid was reduced to less than 2mmol/L with a fairly good treatment effect.ConclusionsThe treatment of ventilator ventilation of SIMV model combined with neap volume and low PEEP protective mechanical ventilation on severely burned patients with severe inhalation injury maintained their respiratory functions,put right hypoxia.The daily revisions of the arterial blood gas analysis showed their PO₂,PCO₂,SO₂ and Lac were satisfactory within the 3 days after ventilation,and there were no related ventilator complications,which were worthy of great promotion.