Efficacy of adaptive ventilation support combined with lung recruitment maneuvering for acute respiratory distress syndrome

Objective: This study was designed to evaluate the efficacy of adaptive support ventilation (ASV) and lung recruitment maneuvering (LRM) on the hemodynamics and respiratory mechanics of patients with acute respiratory distress syndrome (ARDS). Methods: A total of 100 patients with ARDS admitted to the intensive care unit (ICU) of our hospital from July 2016 to October 2019 were randomly divided into the control group (n=50) receiving synchronized intermittent mandatory ventilation (SIMV) and the study group (n=50) receiving ASV + LRM. The hemodynamics, respiratory mechanics, oxygen metabolism parameters, pulmonary index of microcirculatory resistance and prognosis were compared between the two groups. Results: No significant difference was observed between the two groups in terms of baseline data (P > 0.05). Positive end-expiratory pressure (PEEP), mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), systemic vascular resistance index (SVRI), pulmonary arterial pressure (PAP), and cardiac output index (CI) were not significantly different between the two groups (P > 0.05). PEEP, peak inspiratory pressure (PIP), pulmonary vascular resistance index (PVRI), and extravascular lung water (EVLW) were lower, and arterial oxygen pressure (PaO2), global oxygen delivery (DO2), oxygen-uptake (VO2), and dynamic compliance (Cdyn) were higher in the study group than in the control group (P < 0.05). Time to withdrawal, APACHE II score, and length of stay in ICU were lower in the study group than in the control group (P < 0.05). Conclusion: ASV + LRM can improve respiratory mechanics, oxygen metabolism, reduce microcirculatory resistance, shorten ICU stay and alleviate the conditions of ARDS patients, but has no significant effect on hemodynamics.