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급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성

Other Titles
 The Effect and Safety of Alveolar Recruitment Maneuver using Pressure-Controlled Ventilation in 423Acute Lung Injury and Acute Respiratory Distress Syndrome 
 정경수  ;  박병훈  ;  김영삼  ;  김성규  ;  장준  ;  김세규  ;  이선민  ;  김정주  ;  한창훈  ;  박무석  ;  강신명  ;  박선철  ;  전한호  ;  신상윤 
Journal Title
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Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients` data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of 30 cmH2O and a PEEP of 20 cmH2O in a 2-minute PCV mode. The venous O2 saturation, central venous pressure, blood pressure, pulse rate, PaO2/FiO2 ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean PaO2/FiO2 ratio was 130.3 before RM. The PaO2/FiO2 ratio increased by 45% after alveolar RM. The PaO2/FiO2 ratio reached a peak 60 minutes after alveolar RM. The PaCO2 increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Kyu(김성규)
Kim, Se Kyu(김세규)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
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