Đánh giá bước đầu hiệu quả cải thiện oxy hóa máu của phương pháp thông khí cơ học tư thế nằm sấp ở bệnh nhân suy hô hấp cấp tiến triển

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Tác giả: Xuân Thành Đậu, Thị Bích Hoàng, Trương Tuyết Minh Lê, Minh Hải Mai, Đức Nhật Nguyễn, Hồng Tốt Nguyễn, Huyền Trang Nguyễn, Thị Nga Nguyễn, Đăng Hải Phạm, Minh Tâm Phan, Anh Đức Vũ, Quang Hưng Vũ

Ngôn ngữ: vie

Ký hiệu phân loại: 612.21 Biophysics

Thông tin xuất bản: Tạp chí Y dược lâm sàng 108, 2022

Mô tả vật lý: 39-47

Bộ sưu tập: Metadata

ID: 498982

Thêm vào giỏ

Đánh giá bước đầu hiệu quả cải thiện oxy hóa máu của phương pháp thông khí cơ học tư thế nằm sấp ở bệnh nhân suy hô hấp cấp tiến triển tại Trung tâm Hồi sức tích cực, Bệnh viện Trung ương Quân đội 108. Đối tượng và phương pháp: 18 bệnh nhân suy hô hấp cấp tiến triển mức độ trung bình hoặc nặng (PaO2/FiO2 <
150mmHg với PEEP ≥ 5cmH2O, FiO2 ≥ 60%) điều trị tại Khoa Hồi sức tích cực, Bệnh viện TWQĐ 108 từ tháng 02/2020 đến tháng 09/2021 được chỉ định thông khí cơ học tư thế nằm sấp. Kết quả: Tỷ lệ bệnh nhân có cải thiện oxy máu là 83,3%. SpO2, PaO2 cải thiện rõ rệt sau khi nằm sấp 1 giờ và trong suốt thời gian nằm sấp, có ý nghĩa thống kê. Tỷ lệ PaO2/FiO2 tăng lên ngay sau bệnh nhân nằm sấp 1 giờ và tiếp tục cải thiện trong các giờ tiếp theo. Khi bệnh nhân nằm ngửa trở lại 4 giờ thì tỷ lệ PaO2/FiO2 có giảm đi so với khi nằm sấp nhưng vẫn cao hơn so với trước khi nằm sấp, với p<
0,001. Kết luận: Thông khí cơ học tư thế nằm sấp giúp cải thiện oxy hóa máu ở bệnh nhân suy hô hấp cấp tiến triển.To initially evaluate the effectiveness of improving blood oxygenation of prone position mechanical ventilation in patients with acute respiratory distress syndrome (ARDS) at the Intensive Care Unit, 108 Military Central Hospital. Subject and method: 18 patients with moderate or severe ARDS (PaO2/FiO2 <
150mmHg with PEEP ≥ 5cmH2O, FiO2 ≥ 60%) were treated at the Intensive Care Unit, 108 Military Central Hospital from February 2020 to September 2021 were indicated prone position mechanical ventilation. Result: The percentage of patients with improved blood oxygen was 83.3%. SpO2, PaO2 improved significantly after prone positioning for 1 hour and during the time of prone positioning. The PaO2/FiO2 ratio increased immediately after the patient was prone positioning for 1 hour and continued to improve in the following hours. When patients returned to the supine position for 4 hours, the PaO2/FiO2 decreased compared to the prone position but was still higher than before the prone position, with p<
0.001. Conclusion: The prone position mechanical ventilation had improved blood oxygenation in patients with ARDS.

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