Clinical effect of lower tidal volume combine with lung recruitment maneuver on ARDS for post operative esophageal carcinoma surgery patients

Abstract

To study clinical effectiveness and possible side effects of lower tidal volume combine with lung recruitment on acute respiratory distress syndrome (ARDS) for post operative esophageal carcinoma surgery patients. Twenty six hypoxemie post operative esophageal carcinoma surgery patients from Cancer Hospital and Peking Union Medical College Hospital were included from 1st January 2007 to 30th September 2009. There were 20 male and 6 female with an average age of 65.5 years (51 - 76 years). Circulation was stable among them. They could not weaned from mechanical ventilation due to ARDS. Bedside monitoring included noninvasive continuous artery blood pressure (NBP), pulse oximetry saturation (SPO2). Patients were ventilated on volume control mode. Tidal volumes set to 6 ml/kg. Recruitment maneuvers were conducted by stepwise rising of positive end expiratory pressure (PEEP) level. PEEP, fraction of inspired oxygen (FiO2), static compliance of lung (CLS) and arterial blood gas analysis (ABG) before and at 30 min after each of twice applying recruitment maneuvers were measured. Fifty-two recruitments were completed on these 26 cases. PaO2/FiO2 improved significantly in 26 cases. The level of FiO2 were significantly lowered, CLS were increased significantly 30 min after each of twice applying recruitment maneuvers in all 26 cases. No complication was encountered. All patients were discharged successfully. Hypoxemia of ARDS following esophageal carcinoma surgery can be improved by lower tidal volume combine with lung recruitment maneuver.