Effect of NIPPV in the treatment of AECOPD complicated with type Ⅱ respiratory failure and its influence on blood gas index
10.3760/cma.j.issn.1008-6706.2019.11.009
- VernacularTitle: 无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭的疗效及对血气指标的影响
- Author:
Junxiu LI
1
Author Information
1. Department of Respiratory Medicine, the Central Hospital of Shanxi Coal, Taiyuan, Shanxi 030006, China
- Publication Type:Journal Article
- Keywords:
Positive-pressure respiration;
Ventilators, mechanical;
Pulmonary disease, chronic Obstructive;
Respiratory insufficiency;
Blood gas analysis;
Nutrition assessment;
Natriuretic peptide, brain;
Procalcitonin;
Lactic acid
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(11):1316-1320
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of noninvasive positive pressure ventilation(NIPPV) in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with type Ⅱ respiratory failure and its influence on blood gas index.
Methods:From August 2014 to December 2016, the clinical data of 79 patients with AECOPD complicated with type Ⅱ respiratory failure in the Central Hospital of Shanxi Coal were retrospectively analyzed.The patients were divided into two groups according to different treatment methods.Thirty-five patients in the control group were treated with conventional therapy, 44 patients in the observation group were treated with conventional NIPPV.The blood gas index, nutritional index, plasma N-terminal brain natriuretic peptide precursor(NT-proBNP), lactate(Lac) and the changes of procalcitonin (PCT), soluble myeloid cell trigger receptor-1(sTREM-1) level were compared between the two groups.
Results:There were no statistically significant differences in respiratory frequency, blood gas index and APACHE Ⅱ score between the two groups before treatment(P=0.282, 0.177, 0.485, 0.472, 0.485). The levels of pH (7.41±0.07) and PaO2[(82.30±6.99)mmHg]in the observation group were higher than those in the control group(t=9.357, 5.328, P=0.000, 0.000). The respiratory frequency[(20.02±2.15)times/min], PaCO2[(52.36±5.15)mmHg]and APACHE Ⅱ score[(18.20±1.01)points]in the observation group were lower than those in the control group(t=7.782, 10.608, 9.360, P=0.000, 0.000, 0.000). There were no statistically significant differences between the two groups in the levels of nutritional indicators before treatment(t=0.027, 0.039, 0.068, P=0.488, 0.485, 0.473). After treatment, the serum total protein level in the observation group was higher than that in the control group, but the levels of serum albumin and hemoglobin had no statistically significant differences compared with those in the control group(t=3.606, 1.659, 0.034, P=0.000, 0.051, 0.486). There were no statistically significant differences in the levels of Lac, NT-proBNP, inflammatory factors between the two groups before treatment(P=0.465, 0.477, 0.451, 0.493). The levels of Lac[(1.57±0.55)mmol/L], NT-proBNP[(130.25±42.36)ng/L], PCT[(0.16 ±0.09)g/L], sTREM-1[(66.36±12.87)ng/L]in the observation group were lower than those in the control group(t=7.662, 2.248, 4.030, 2.709, P=0.000, 0.014, 0.000, 0.004). After treatment, the respiratory rate, blood gas index and APACHE Ⅱ score of the two groups were improved compared with those of the control group(all P<0.05). The respiratory rate per minute, pH, PaO2, PaCO2 and APACHE Ⅱ scores in the observation group were better than those in the control group(all P<0.05). The levels of serum total protein, hemoglobin and Lac, NT-proBNP, inflammatory factors in the two groups were lower than those before treatment, and the levels of serum total protein and Lac, NT-proBNP, PCT, sTREM-1 in the observation group were higher than those in the control group(all P<0.05). The serum albumin level in the control group after treatment was lower than that before treatment, and there was no statistically significant difference between the two groups after treatment(P>0.05).
Conclusion:NIPPV in the treatment of AECOPD complicated with type Ⅱ respiratory failure can effectively improve the blood gas status and nutritional status of patients, and reduce the body Lac and NT-proBNP levels.
