Invasive Ventilation in Critical Patients with Severe Acute Respiratory Syndrome(SARS)_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Lixin , YU Tieou , FANG Bin , LI Yinan , WEN Weibiao , ZOU Yicheng , MA Mingyuan , MAO Kejiang

The First people’s Hospital of Foshan; Foshan 528000; China;

Corresponding author：

Keywords：

Severe acute respiratory syndrome; Invasive ventilation; Lung-protection strategy; Isolating and protecting

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Objective 　To study the efficacy of invasive ventilation in critical severe acute respiratory syndrome (SARS).
Methods 　Retrospective analysis was applied to study the efficacy of invasive ventilation and the effect of isolating and protecting measures in 6 critical SARS patients and the effect of isolation measures in ICU from November 2002 to April 2003.
Results 　Six SARS patients were successfully weaned from mechanical ventilation and left hospital. Hypoxemia and oxygenation index（PaO2/FiO2）improved significantly after ventilation (P lt;0.01), peak inspiratory airway pressure (P=0.002), mean airway pressure (P=0.004), and the level of positive expiration end pressure decreased significantly (P lt;0.001). Ventilator-associated pneumonia occurred in 5 patients. Sedatives were used less and the duration of ventilation was shorter when using PRVC compared with SIMV. There was no SARS nosocomial infection among medical staff, other patients and their families.
Conclusions 　Application of invasive ventilation and effective isolation measures could reduce the death rate, shorten the duration of ventilation, and also decrease SARS nosocomial infection.

Citation： ZHOU Lixin,YU Tieou,FANG Bin,LI Yinan,WEN Weibiao,ZOU Yicheng,MA Mingyuan,MAO Kejiang. Invasive Ventilation in Critical Patients with Severe Acute Respiratory Syndrome(SARS). Chinese Journal of Evidence-Based Medicine, 2004, 04(8): 573-577. doi: Copy

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11.	［8］Yin ZB, Zhang FC, Tang XP, Chen WL, Chen YQ, Wang J, Jia WD. Measurement of subsets of blood T lymphocyte in 93patients with severe acute respiratory syndrome[J]. Clin J Tubere Respir Dis, 2003,26(6): 343 -346.
12.	尹志标,张复春,唐小平,陈伟烈,陈燕清,王健,贾卫东.93例传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义[J].中华呼吸和结核杂志,2003;26(6):343～346.
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1. ［1］Chinese Medical Association, China Association of Chinese Medicine. The scheme of diagnosis and therapy of severe acute respiratory syndrome (SARS) [J]. Natl Med J China, 2003;19:1731 -1752.
2. 中华医学会,中华中医药学会.传染性非典型肺炎(严重急性呼吸综合征,SARS)诊疗方案[J].中华医学杂志,2003;19 :1 731～1 752.
3. ［2］The General Office of Health Ministry. The clinical diagnosis criterian of severe acute respiratory syndrome (proposed) and the diagnosis criterian of severe infective untypical pneumonia. May 3rd, 2003 Aailable from: URL: http://www. mob gov. cn/zhgl/zt/1200305040087. htm.
4. 卫生部办公厅.传染性非典型肺炎临床诊断标准(试行)和重症非典型肺炎诊断标准.2003年5月3日Aailable from:URL:http://www. moh. gov. cn/zhgl/zt/1200305040087. htm.
5. ［3］Zhou LX, TanJJ, Wu M, Luo HT, Yu TO, Kang P, Fang B, Li YN, Wen WB, Zou YC. The first case of severe acute respiratory syndrome in Foshan [ J ]. Chin J Tubere Respir Dis,2003, 26(10) :598 -601.
6. 周立新,谭家驹,吴敏,罗红涛,誉铁鸥,康萍,方滨,李轶男,温伟标,邹毅成.广东省佛山市严重急性呼吸综合征首例报告[J].中华结核和呼吸杂志,2003,26(10):598～601.
7. ［4］Lu Q, Vieira SR, RichecoeurJ, Puybasset L, Kalfon P, Coriat P, Rouby JJ. A simple automated method for measuring pressure-volume curves during mechanical ventilation. Am J Respir Crit Care Med, 1999; 159: 275 - 282.
8. ［5］Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL,Bowton DL, Haponik EF. Predictors of successful extubation in eurosurgical patients[J]. Am J Respir Crit Care Med, 2001; 163(3 Pt 1) :658 -664.
9. ［6］Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure [J ]. Crit Care (Lond) ,1997 ;1 (2) :75 -77.
10. ［7］Mancini M, Zavala E, Mancebo J, Fernandez C, Barbera JA,Rossi A, Roca J, Rodriguez-Roisin R. Mechanisms of pulmonary gas exchange improvement during a protective ventilatory strategy in acute respiratory distress syndrome [J]. Am J Respir Crit Care Med, 2001; 164(8 Pt 1 ) :1 448 - 1 453.
11. ［8］Yin ZB, Zhang FC, Tang XP, Chen WL, Chen YQ, Wang J, Jia WD. Measurement of subsets of blood T lymphocyte in 93patients with severe acute respiratory syndrome[J]. Clin J Tubere Respir Dis, 2003,26(6): 343 -346.
12. 尹志标,张复春,唐小平,陈伟烈,陈燕清,王健,贾卫东.93例传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义[J].中华呼吸和结核杂志,2003;26(6):343～346.
13. ［9］Wong KT, Antonio GE, Hui DS, Lee N, Yuen EH, Wu A, Leung CB, Rainer TH, Cameron P, Chung SS, Sung JJ,Ahuja AT. Severe Acute Respiratory Syndrome: Radiographic Appearances and Pattern of Progression in 138 Patients[J]. Radiology, 2003; 228(2):401 -406.

Chinese Journal of Evidence-Based Medicine

Invasive Ventilation in Critical Patients with Severe Acute Respiratory Syndrome(SARS)

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