COMPARATIVE STUDY BETWEEN SMALL TIDAL voJUME VENTILATION WITH AND WITHOUT SUSTAINED INFLATION MANEUVER IN ARDS PATIENTS

Abstract

This study was carried out to assess the safety and efficacy of a sustained inflation, used as a lung volume recruitment maneuver in mechanically ventilated patients with ARDS, and comparing it with the new method of building up PEEP with small tidal volume.

The study was conducted on 20 patients admitted to the critical care department of Alexandria Main University Hospital fulfilling the criteria of ATS-ESICM for the diagnosis of ARDS. These patients essentially required mechanical ventilatory support.

Patients included in the study were subjected to thorough physical examination and history taking, arterial cannulation for arterial blood gas analysis every 4 hours, plain chest radiography, and central venous line application.

On admission, samples taken from the arterial line and central venous line were analyzed to obtain arterial oxygen tension, arterial oxygen saturation, arterial carbon dioxide tension, central venous oxygen tension, and central venous oxygen saturation at a given fraction of inspired oxygen. Hemoglobin level was obtained from the routine laboratory investigations done to the patient on admission, which included a complete blood count. These data were used to calculate the alveolar oxygen tension, pulmonary capillary oxygen content, arterial oxygen content, and central venous oxygen content that was used instead of mixed venous oxygen content to calculate the shunt fraction.