俯卧位通气联合体外膜肺氧合在难治性呼吸衰竭中的疗效

Abstract: Objective To explore the efficacy of prone position ventilation combined with extracorporeal membrane oxygenation (ECMO) in refractory respiratory failure. Methods A total of 72 patients with refractory respiratory failure from August 2023 to April 2025 were selected as the research subjects and randomly divided into two groups by envelope method, with 36 cases in each group. The control group was treated with ECMO, while the observation group was treated with prone position ventilation based on the control group. The efficacy of the patients in both groups were evaluated after 2 weeks of treatment. Results The lung function of both groups was improved after the intervention. The forced expiratory volume in one second (FEV1), vital capacity (FVC), and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) in the observation group were higher than those in the control group (P＜0.05). The partial pressure of oxygen (PaO2) in the observation group after intervention was higher than that in the control group (P＜0.05). The partial pressure of carbon dioxide (PaCO2) was lower than that of the control group (P＜0.05). After the intervention, the C-reactive protein (CRP), neutrophil-tolymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in the observation group were lower than those in the control group (P＜0.05). After the intervention, the levels of transforming growth factor -β1 (TGF-β1) and angiotensin II (Ang-II) in the observation group were lower than those in the control group (P＜0.05). Angiotensin I (Ang-I) was higher than that of the control group (P＜0.05). There was no statistically significant difference in safety between the two groups of patients (P＞0.05). Conclusion Prone position ventilation combined with ECMO has a good effect in patients with refractory respiratory failure. It can improve the lung function of patients, improve the blood gas level, help reduce the inflammatory response in the body, alleviate airway remodeling, and does not increase the incidence of adverse reactions. It is worthy of promotion and application.