Abstract
Objective: to study the specific features of pulmonary gas exchange and mechanical properties in various manifestations of respiratory failure in miners with severe concomitant injury, who have a service length of 10 years or more, in order to optimize respiratory support. Subjects and methods. Pulmonary gas exchange and mechanical properties were studied over time in the presence of respiratory failure (acute lung injury/acute respiratory distress syndrome) in 34 miners and 36 victims (a control group) with severe concomitant injury who had no underground service length. Both groups were matched in age, severity and nature of traumatic lesions and surgical interventions. Pulmonary gas exchange and mechanical properties were evaluated by the following indices: oxygen fraction in an inspired gas mixture; hemoglobin saturation and partial arterial blood oxygen and carbon dioxide tension with the alveolar-arterial gradient being calculated by the oxygen level; oxygenation index; intrapulmonary shunting; statistical compliance and airways resistance. Results. The studies demonstrated that the miners, as compared with the controls, had more pronounced gas exchange changes within 5—7 post-traumatic days; later on (days 7—9) the above differences were undetectable. Impaired pulmonary mechanical properties in the miners persisted throughout the study while in the control group, their recovery started just on day 3. The course of respiratory failure in the miners was attributable to the baseline external respiratory function. Their respiratory support was performed during 14.5±1.4 days versus 9.5±1.9 days in the controls. In the miners, the mean bed-days at an intensive care unit were 18.5±2.2 whereas in the controls those were 12.3±2.1. Conclusion. More significant impairments of pulmonary gas exchange and mechanical properties are seen in the miners due to the background changes in external respiratory function in the development of respiratory function after severe concomitant traumatic lesions than in the victims without underground service length, which causes an increase in the duration of respiratory support and intensive care.
Highlights
Pulmonary gas exchange and mechanical properties were studied over time in the presence of respiratory failure in 34 miners and 36 vic tims with severe concomitant injury who had no underground service length
Pulmonary gas exchange and mechanical prop erties were evaluated by the following indices: oxygen fraction in an inspired gas mixture; hemoglobin saturation and par tial arterial blood oxygen and carbon dioxide tension with the alveolar arterial gradient being calculated by the oxygen level; oxygenation index; intrapulmonary shunting; statistical compliance and airways resistance
More significant impairments of pul monary gas exchange and mechanical properties are seen in the miners due to the background changes in external respira tory function in the development of respiratory function after severe concomitant traumatic lesions than in the victims with out underground service length, which causes an increase in the duration of respiratory support and intensive care
Summary
Исследования были проведены у 70 пострадавших с тяжё лой сочетанной травмой, получавших лечение в отделении реа нимации. 24 м (66,6 %) пострадавшим контрольной группы также проводили оперативные вмешательства. У пострадавших основной и контрольной групп дыха тельная недостаточность проявлялась в виде острого по вреждения лёгких (ОПЛ) или острого респираторного дис тресс синдрома (ОРДС) различной степени тяжести как следствие реализации одного или нескольких патологичес ких процессов (длительная артериальная гипотензия, уши бы легких, жировая эмболия, аспирационный синдром, пневмония и др.). В течение всего периода лечения в отделении реанимации пострадавшим основной и контрольной групп проводилось комплексное обследование, включающее клиническую оценку состояния, мониторинг основных показателей гемодинамики, общеклинические, бактериологические, биохимические иссле дования биологических жидкостей (крови, мочи, ликвора) и инструментальные методы исследования (компьютерная то мография, рентгенография органов грудной клетки, диагнос тические лапароскопии и бронхоскопии). Показатели динамики газообмена и механических свойств легких у шахтеров и пострадавших контрольной группы с тяжелой сочетанной травмой при развитии легочных осложнений (M±m)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
