Effects of respiratory system elasticity resistance on oxygenation after recruitment maneuvers of ALI patients: a meta-analysis
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.1671-0282.2011.04.003
- Key Word:
- 肺复张;急性肺损伤;肺泡塌陷;呼吸系统弹性阻力;胸腔内压;氧合指数;血压;荟萃分析;Recruitment maneuver;ALI;Alveoli collapse;Respiratory system elasticity resistance;Intrathoracic pressure;Oxygenation;Blood pressure;Meta
Abstract： Objective To investigate the effects of elasticity resistance (Ers) in respiratory system on oxygenation in patients with acute lung injury (ALI) after recruitment maneuvers (RM). Method Meta-analysis of data about the effects of recruitment maneuvers on oxygenation in ALI patients with different elasticity resistances in respiratory system carried out with pooling of study-oriented data stored in Pubmed, Embase, Web of Science databases from January 1999 to June 2010. Results A total of 281 articles were taken, and 20 of them included a sample size of 395 ALI patients. In patients treated with RM in different degrees of respiratory system elasticity resistance ( ≥33.3 cmH2O/L and ＜33.3 cmH2O/L), the effect of RM was better in patients with the high respiratory system elasticity resistance than that with the low one [(51.97 + 8.89) mmHg vs. (35.13 ± 10.33 ) mmHg], P ＜ 0. 01 ), but the high respiratory system elasticity resistance was potentially to lower blood pressure [(4. 33 ± 1.32 ) mmHg vs. (0.22 ± 1.03 ) mmHg],P ＜ 0.01 ). Conclusions This study suggests RM could improve oxygenation of ALI patients with high respiratory system elasticity resistance, and caution must be made to avoid hypotension during RM.
- [1]邱海波,黄英姿.急性呼吸窘迫综合征机械通气的新出路[J].2010,(3).
- [2]李家琼,邱海波,杨毅,等.肺保护性通气联合肺复张对急性呼吸窘迫综合征家兔气体交换影响[J].2006,(11).
- [3]GUO Feng-mei,DING Jing-jing,SU Xin,etc.Effects of different levels of end-expiratory positive pressure on lung recruitment and protection in patients with acute respiratory distress syndrome[J].2008,(22).
- [4]Lapinsky SE,Meade MO,Ferguson ND,etc.Recruitment maneuvers for acute lung injury: a systematic review.[J].2008,178(11).
- [5]Wolfgang, Oczenski,Christoph, H?rmann,Christian, Keller,etc.Recruitment maneuvers during prone positioning in patients with acute respiratory distress syndrome.[J].2005,33(1).
- [6]Claesson J,Winso O,Lehtipalo S.Do lung recruitment maneuvers decrease gastric mucosal perfusion?[J].2003,29(8).
- [7]Gallix B,Sebbane M,Bazin JE,etc.Lung morphology predicts response to recruitment maneuver in patients with acute respiratory distress syndrome.[J].2010,38(4).
- [8]Bruhn A,Bugedo G,Rojas G,etc.Lung computed tomography during a lung recruitment maneuver in patients with acute lung injury.[J].2003,29(2).
- [9]P, Pelosi,P, Cadringher,N, Bottino,etc.Sigh in acute respiratory distress syndrome.[J].1999,159.
- [10]Kitsakos A,Kostanti E,Svarna E,etc.Prone position augments recruitment and prevents alveolar overinflation in acute lung injury.[J].2006,174(2).
- [11]Park KJ,Oh YJ,Chang H.Acute hemodynamic effects of recruitment maneuvers in patients with acute respiratory distress syndrome.[J].2009,24(6).
- [12]Caironi,P.,Cressoni,M.,Chiumello,D.,etc.Lung opening and closing during ventilation of acute respiratory distress syndrome[J].2010,181(6).
- [13]G, Foti,M, Cereda,M E, Sparacino,etc.Effects of periodic lung recruitment maneuvers on gas exchange and respiratory mechanics in mechanically ventilated acute respiratory distress syndrome (ARDS) patients.[J].2000,26(5).
- [14]Villagra A,Del Mar Fernandez M,Fernandez R,etc.Recruitment maneuvers during lung protective ventilation in acute respiratory distress syndrome.[J].2002,165(2).
- [15]Nicoló,Patroniti,Giuseppe Foti,etc.Sigh Improves Gas Exchange and Lung Volume in Patients with Acute Respiratory Distress Syndrome Undergoing Pressure Support Ventilation[J].2002,96(4).
- [16]Salvatore Grasso,Luciana Mascia,Monica Del Turco,etc.Effects of Recruiting Maneuvers in Patients with Acute Respiratory Distress Syndrome Ventilated with Protective Ventilatory Strategy[J].2002,96(4).
- [17]Jay A, Johannigman,Sandra L, Miller,Bradley R, Davis,etc.Influence of low tidal volumes on gas exchange in acute respiratory distress syndrome and the role of recruitment maneuvers.[J].2003,54(2).