THE INFLUENCE OF DIFFERENT VENTILATION PATTERNS ON TREATMENT OF PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

O. V. Oliynyk, B. O. Pereviznyk, A. Shlifirchyk

Abstract


Background. Respiratory support is a vital method for temporary compensation of external breathing function in patients with severe traumatic brain injury. However, it is not always possible to deal with severe respiratory dysfunction even with the usage of up-to-date respiratory technologies. This work is aimed to find an answer how different pattern of mechanical ventilation influence on a treatment of patients with severe traumatic brain injury.

Objective. The influence of respiratory support, as a main method for temporary compensation of external breathing function, on treatment result for patients with severe traumatic brain injury.

Methods. Treatment results of 253 patients with severe traumatic brain injury of Ternopil University Hospital were evaluated due to the type of respiratory support used. The results were separately evaluated in alive and dead patients.

Results. Mortality rate of patients depended on the type of mechanical ventilation that was used. The highest mortality (58.69 %) was in the group, when a patient was transferred to forced ventilation a volume control. The mortality rate was decreasing by 51.78% in case of adding PEEP. The strategy of using accessory lung ventilation patterns CPAP and BiPAP caused significant (in 1.48 times) decrease of mortality in this group of patients.

Conclusion The survival of patients with severe traumatic brain injury, who were ventilated by the method of consistent combination of forced ventilation with pressure control (CРV) and 2 patterns of accessory lung ventilation: Constant Positive Airway Pressure (CPAP) and Biphasic positive airway pressure (BiPAP), is reliably higher than in the case of forced ventilation with volume control with Positive end-expiratory pressure.


Keywords


severe traumatic brain injury; lung ventilation; treatment; intensive care.

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DOI: http://dx.doi.org/10.11603/ijmmr.2413-6077.2016.2.7031

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