rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2007-3-7rmt-1010Research ArticleОСТРАЯ ДЫХАТЕЛЬНАЯ НЕДОСТАТОЧНОСТЬACUTE RESPIRATORY FAILUREРеспираторная терапия у больных с острым повреждением легких и сопутствующим пневмотораксомRespiratory Therapy in Patients with Acute Lung Injury and Concomitant PneumothoraxМарченковЮ. ВMarchenkovYu. V.-МорозоваО. А.MorozovaO. A.-ОстапченкоД. А.OstapchenkoD. A.-20072006200733Том III № 3 2007 г.77Copyright © Марченков Ю.В., Морозова О.А., Остапченко Д.А., 20072007Марченков Ю.В., Морозова О.А., Остапченко Д.А.Marchenkov Y.V., Morozova O.A., Ostapchenko D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1010

Цель — сравнить исследование эффективности респираторной поддержки с использованием BIPAP (вентиляция легких с двухфазным положительным давлением в дыхательных путях), SIMV (синхронизированная перемежающаяся принудительная вентиляция легких) и IPPV (вентиляция легких с положительным давлением в дыхательных путях) у больных с острым повреждением легких (ОПЛ) и сопутствующим пневмотораксом. Материалы и методы. Обследовано 68 больных. Тяжесть состояния по шкале APACНЕ II составила 18—24 баллов. После ликвидации пневмоторакса проводили «маневр открытия легких» на различных видах респираторной поддержки 1—2 раза в сутки, по общепринятой методике. Результаты. В результате исследования показано, что использование BIPAP у больных с ОПЛ и сопутствующим пневмотораксом снижает время дренирования плевральной полости, что позволяет раньше использовать маневр открытия легких. Заключение. Применение BIPAP приводит к лучшей адаптации больного к респиратору, ограничению применения седатив-ных средств, улучшению газообмена в легких и ускоряет переход от тотальной респираторной поддержки к самостоятельному дыханию. Ключевые слова: острое повреждение легких, пневмоторакс, BIPAP, маневр открытия легких.

Objective. To comparatively study the efficiency of respiratory support using biphasic positive airway pressure (BIPAP), spontaneous intermittent mandatory ventilation (SIMV), and intermittent positive pressure ventilation (IPPV) in patients with acute lung injury (ALI) and concomitant pneumothorax. Subjects and materials. Sixty-eight patients were examined. The severity of disease was 18 to 24 APACHE II scores. After elimination of pneumothorax, lung opening maneuver was made by the routine procedure 1—2 times daily on different types of respiratory support. Results. The study has indicated that in patients with ALI and concomitant pneumothorax, BIPAP reduces the time of pleural cavity drainage, which allows the lung opening maneuver to be earlier used. Conclusion. BIPAP leads to a better adaptation of a patient to respiratory support, to the limited use of sedatives, and to better gas exchange in the lung and accelerates transfer from total respiratory support to spontaneous breathing. Key words: acute lung injury, pneumothorax, BIPAP, lung opening maneuver.

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The authors declare that there are no conflicts of interest present.