Early diagnosis and tactics of respiratory therapy in patients with ventilation-associated pneumonia
Oshuev, S.V.; Kokhno, V.N.
Anesteziologiia i Reanimatologiia 2: 50-53
2010
ISSN/ISBN: 0201-7563 PMID: 20524333 Document Number: 642546
The study included 70 patients undergone prolonged artificial ventilation (AV) in the early postoperative period. The early diagnosis of pneumonia was established on the basis of the maximum light flux rate (MLFR) of an expired air condensate. In this study 36 hours after the initiation of respiratory support there was a significant increase in MLFR of spontaneous and induced luminescence in the group in which the patients subsequently developed ventilation-associated pneumonia as compared with that in which the patients did not develop pneumonia, which allowed its early diagnosis to be made. Various AV modes were comparatively analyzed in patients with ventilation-associated pneumonia. Respiratory support was used in tandem in the following modes: controlled volume ventilation (IPPV), volume- and pressure-regulated ventilation (IPPV Auto Follow), and biphasic pressure support ventilation (BPSV). In each mode of ventilation, blood gas composition was studied and the resultant values of AV were recorded. As compared with IPPV and BPSV, IPPV Auto Follow was significantly characterized by the least pressure drop in the respiratory circuit (p < 0.05), which corresponded to the concept of safe respiratory support.