Study on the effects of different tidal volume ventilation on respiratory mechanics and hemodynamics in children with severe pneumonia

doi:10.11958/20250327

Abstract

Abstract:

Objective To investigate the effect of ventilation with different tidal volumes on respiratory mechanics and haemodynamics in children with severe pneumonia. Methods A total of 104 children with severe pneumonia were divided into the control group and the observation group using a random number table method, with 52 cases in each group. Both groups underwent mechanical ventilation treatment. The control group was treated with conventional tidal volume of 10-12 mL/kg, while the observation group was given a low tidal volume of 6-8 mL/kg. The respiratory mechanics indicators, hemodynamic indicators and inflammatory factor indicators before and after treatment were compared between the two groups. Results After treatment, the airway resistance (AR) and airway closing pressure (AOP) were lower in the observation group than those of the control group (P<0.05), and pulmonary dynamic compliance (Cdyn) was higher in the observation group than that of the control group (P<0.05). There were no significant differences in heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) after treatment between the two groups (P<0.05). After treatment, the levels of interleukin (IL）-6, IL-8 and tumor necrosis factor-α (TNF-α) were all lower in the observation group than those in the control group (P<0.05). Conclusion Small tidal volume mechanical ventilation is effective in improving the respiratory mechanics of children with severe pneumonia without causing large fluctuations in their hemodynamics. At the same time, it can reduce the level of inflammatory factors in the organism.

Key words: tidal volume, respiration, artificial, respiratory mechanics, hemodynamics, severe pneumonia

CLC Number:

R725.6

Figures/Tables 4

References 20

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组别	n	性别（男/女）	年龄/岁	体质量/kg	病程/d
对照组	52	28/24	3.89±0.74	10.13±2.30	10.21±1.57
观察组	52	29/23	4.02±0.81	10.84±2.63	10.43±1.42
χ²或t		0.039	0.854	1.465	0.749

组别	n	性别（男/女）	年龄/岁	体质量/kg	病程/d
对照组	52	28/24	3.89±0.74	10.13±2.30	10.21±1.57
观察组	52	29/23	4.02±0.81	10.84±2.63	10.43±1.42
χ²或t		0.039	0.854	1.465	0.749

组别	AR/[cmH₂O/（L·s）]			AOP/（cmH₂O）			Cdyn/（mL/cmH₂O）
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	95.76±7.46	42.97±8.46	37.173^＊＊	2.00±0.54	3.85±0.52	18.496^＊＊	2.51±0.42	4.93±0.51	28.173^＊＊
观察组	93.44±6.78	37.71±2.38	54.989^＊＊	1.92±0.60	3.51±0.34	17.864^＊＊	2.68±0.49	5.36±0.19	34.935^＊＊
t	1.660	5.175^＊＊		0.748	4.035^＊＊		1.892	5.642^＊＊

组别	AR/[cmH₂O/（L·s）]			AOP/（cmH₂O）			Cdyn/（mL/cmH₂O）
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	95.76±7.46	42.97±8.46	37.173^＊＊	2.00±0.54	3.85±0.52	18.496^＊＊	2.51±0.42	4.93±0.51	28.173^＊＊
观察组	93.44±6.78	37.71±2.38	54.989^＊＊	1.92±0.60	3.51±0.34	17.864^＊＊	2.68±0.49	5.36±0.19	34.935^＊＊
t	1.660	5.175^＊＊		0.748	4.035^＊＊		1.892	5.642^＊＊

组别	HR/（次/min）			MAP/（mmHg）			CVP/（cmH₂O）
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	108.11±14.68	91.52±12.48	5.437^＊＊	91.05±13.89	84.65±4.09	3.278^＊	13.13±0.67	10.78±2.96	6.162^＊＊
观察组	106.21±6.43	95.77±11.55	5.903^＊＊	89.27±11.70	83.07±9.41	3.198^＊	12.89±0.83	9.91±2.46	8.533^＊＊
t	0.856	1.803		0.708	1.115		1.655	1.636