Analysis of the efficacy of invasive positive pressure ventilation and noninvasive positive pressure ventilation in AECOPD patients
10.3760/cma.j.issn.1008-6315.2012.09.010
- VernacularTitle:慢性阻塞性肺疾病急性加重合并呼吸衰竭患者有创与无创机械通气的疗效分析
- Author:
Maoxing QU
;
Jian YU
- Publication Type:Journal Article
- Keywords:
Chronic obstructive pulmonary disease;
Invasive positive pressure ventilation;
Noninvasive positive pressure ventilation
- From:
Clinical Medicine of China
2012;28(9):927-930
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo compare the different efficacy between invasive positive pressure ventilation andnoninvasivepositivepressureventilationofacuteexacerbationchronicobstructivepulmonary disease.Methods Patients with acute exacerbation chronic obstructive pulmonary disease were randomly divided into invasive positive pressure mechanical ventilation ( IPPV ) group ( n =35 ) and noninvasive positive pressure mechanical ventilation (NPPV)group (n =37 ),and clinical data before and after treatment were analyzed retrospectively.ResultsAfter 2 hours of invasive positive pressure mechanical ventilation,pH,arterial oxygen partial pressure( PaO2 ),arterial carbon dioxide partial pressure ( PaCO2 ),heart rate ( HR ),respiratory rate(RR),Glasgow coma scale(GCS) score were better than those before treatment[ pH:(7.35 ± 0.05)vs ( 7.23 ± 0.02 ) ; PaO2:( 92.4 ± 14.5 ) mm Hg vs ( 51.3 ± 9.4 ) mm Hg; PaCO2:( 56.0 ± 7.7 ) mm Hg vs( 82.6 ±8.1)mm Hg;GCS:(10.5 ± 1.1)points vs(8.5 ± 1.2)points;HR:(110 ± 12) times/min vs(131 ± 19) times/min ; RR:( 26 ± 4) times/min vs ( 35 ± 8 ) times/min ; P ＜ 0.05 or P ＜ 0.01 ].But in NPPV group,only the PaO2,HR,RR were better than those before treatment [ PaO2:( 78.6 ± 8.8 )mm Hg vs ( 53.1 ± 8.9 ) mm Hg; HR:( 110 ± 24) times/min vs ( 128 ± 23 ) times/min ; RR:( 26 ± 5 ) times/min vs ( 36 ± 9 ) times/min; P ＜ 0.05 ].And after 6 hours,pH,PaCO2,GCS score were significantly better in NPPV group [ pH:( 7.35 ± 0.03 ) vs ( 7.25 ±0.01 ) ;PaCO2:(59.0 ±6.3) mm Hg vs(79.8 ±7.0) mm Hg;GCS:( 10.6 ± 2.0) points vs( 8.5 ±2.5) points;P ＜ 0.05 or P ＜ 0.01 ].There was no difference on the days in ICU [ ( 15 ± 4) d vs ( 14 ± 4 ) d,t =1.102,P ＞0.05 ],the duration of mechanical ventilation[ ( 168 ± 25 )d vs( 170 ± 23 )d,t =1.214,P ＞ 0.05 ],the mortality in ICU (22.8％ (8/28) vs 21.6％ (8/37),x2 =0.016,P ＞ 0.05) between IPPV group and NPPV group.ConclusionIPPV can improve the situation of AECOPD quickly,but in NPPV group some patients need intubation.However,there was no significant difference on the days in ICU,the duration of mechanical ventilation,the mortality in ICU between IPPV and NPPV.
