From January 1996 to December 1998, 15 patients in the ICU of Bach Mai Hospital were enrolled in the study. All of tem had the signs of dynamic pulmonary hyperinflation. The patients were put under ventilation with parameters as follows: Vt: 8-10 ml/kg; f: 12-16; I/E: 1/3; EIP: 0-10%. These parameters were modified during the process of ventilation in order to obtain the optimal improvement of the patients such as: reduced breathless, stable hemodynamic condition, Pplat < 35 mmHg, SpO2 92%, pH: 7.3 -7.45, PaO2>=60 mmHg. Results: the iPEEP values in our mechanical ventilated patients have been found to average 8-13 cmH2O. PEEPe = 0.5 x iPEEP, significantly reduced iPEEP and patient - ventilator dissynchrony without detrimental effects to hemodynamic condition and airway pressures.
Respiration, Artificial ; Lung Neoplasms ; Ventilation ; Pulmonary Disease, Chronic Obstructive

To suggest the guide for indication of IV and NPPV for ARF of COPD, from January 1996 to May 1998, a prospective clinical trial was carried out in 57 COPD patients with ARF at the ICU of Bach Mai hospital. NPPV was indicated without severe complications. IV was indicated for 42 patients, the mortality rate decreased from 73% (1991-1994) to 28.5% (1996 - 1998). 2 patients in the IV group were extubated and successfully followed by NPPV. We conclude that, NPPV should be attempted before the decision of intubation or tracheotomy is made. IV with the moderate minute volume had very good effectiveness in severe ARFCOPD. We also suggest a guide for indications of NPPV and IV for ARFCOPD.
Intermittent Positive-Pressure Ventilation ; respiratory failure ; Pulmonary Disease, Chronic Obstructive

The study was carried out on 42 patients with acute respiratory failure due to COPD at A9 Department of Bach Mai Hospital from January 1996 to May 1998, in which 54.4% of patients with serious acute respiratory failure. Results showed that 7.14% of patients survived, 21.23% of patients died and 7.14% of patients dropped out of study. Mortality rate in the life-threatening group was 39.13% (9/23 patients): 0% in the severe group. Conclusion: the moderate minute volume - ventilation had very good effectiveness in Acute Respiratory Failure on COPD patients (especially in the severe group).
Respiration, Artificial ; respiratory failure ; Pulmonary Disease, Chronic Obstructive

The diagnosis of severity of the acute respiratory failure plays an important role for properly managing. The causes of the acute respiratory failure due to the chronic obstructive pulmonary disease included infection (first leading cause), cardiac functional disorder, emphysema and irrational drugs. The treatment of acute respiratory failure involved to the management of reduction of blood oxygen respiratory acidosis, bronchospasm, removal of sputum, prevention and control of complications, and use of antibiotics and corticoids.
Pulmonary Disease, Chronic Obstructive ; respiratory failure ; therapeutics

Non-invasive negative pressure and non-invasive positive pressure ventilation are 2 methods of ventilation for patients with the acute respiratory failure currently. The NNPV is not frequently used for patients with the chronic obstructive pulmonary disease (COPD) and the chronic obstructive pulmonary disease induced acute respiratory failure. While NPPV only is unrecalled supportive measure for the invasive positive pressure ventilation in the severe cases and should be early indicated in the acute period of the chronic obstructive pulmonary disease.
Respiration, Artificial ; Pulmonary Disease, Chronic Obstructive