The selection of parameters of invasive pulmonary ventilation in patients with pulmonary contusion complicated by the development of acute respiratory distress syndrome

Abstract

The authors of the paper highlight the content of the algorithm for selecting the parameters of invasive respiratory support for patients with thoracic trauma and pulmonary contusion complicated by the development of acute respiratory distress syndrome. In the process of conducting intensive therapy in 112 such patients, the authors developed and proposed for further use the procedure for step-by-step selection of the ventilation mode and ventilation parameters, which quickly ensures the normalization of the oxygen saturation of the peripheral arterial blood. At the beginning of invasive respiratory support, the authors suggest choosing the mode of controlled mechanical ventilation with pressure regulation. The selected peak pressure should ensure a respiratory volume of 4-8 ml/kg of predicted body weight. Other parameters has selected according to the Murray lung injury severity rating score. It is permissible to increase the driving pressure to 15-16 cm of water column, if the pressure of the plateau does not exceed 30 cm of water column.