Clinical Analysis on Noninvasive Ventilator in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Respiratory Failure_West China Medical Journal

Authors：

 HUANGLiu-qiu ,  LIShao-jun

Department of Respiratory Medicine, Hospital of Guangxi Liuzhou Iron and steel(Group) Company, Liuzhou, Guangxi 545000, P. R. China;

Corresponding author：

LIShao-jun, Email: 120689690@qq.com

Keywords：

Bilevel positive airway pressure; Chronic obstructive pulmonary disease; Respiratory failure

DOI：

10.7507/1002-0179.20140551

Video：

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Objective To observe the clinical curative effect of bilevel positive airway pressure (BiPAP) noninvasive ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure. Methods The clinical materials of 80 patients with AECOPD with respiratory failure were reviewed and analyzed from January 2010 to December 2012. The patients were divided into two groups based on whether BiPAP mechanical ventilation therapy was implemented or not. The vital signs and arterial blood gas analysis, curative effect and medical expenses were compared between the two groups. Results The indexes of vital signs and blood gas analysis before and after treatment showed the consistency of the trend of gradual improvement (P<0.05). After 3-day treatment, the indexes of vital signs and blood gas analysis in the study group were significantly better than the control group (P<0.05). Compared with the control group, the total effective rate was significantly higher, the hospital stay was significantly shorter, the intubation was significantly less, and the medical expenses were significantly lower in the study group (P<0.05). Conclusion The BiPAP non-invasive ventilator has significant effect in improving vital sign, index of blood gas analysis, rate of endotracheal intubation and length of stay, which is worthy of further promotion.

Citation： HUANGLiu-qiu, LIShao-jun. Clinical Analysis on Noninvasive Ventilator in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Respiratory Failure. West China Medical Journal, 2014, 29(10): 1810-1813. doi: 10.7507/1002-0179.20140551 Copy

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2.	Agarwal R, Gupta R, Aggarwal AN, et al. Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs other causes:effectiveness and predictors of failure in a respiratory ICU in North India[J]. Int J Chron Obstruct Pulmon Dis, 2008, 3(4):737-743.
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11.	Bassanezi BS, Oliveira-Filho AG, Miranda ML, et al. Use of BiPAP for safe anesthesia in a child with a large anterior mediastinal mass[J]. Paediatr Anaesth, 2011, 21(9):985-987.
12.	Roy B, Cordova FC, Travaline JM, et al. Full face mask for noninvasive positive-pressure ventilation in patients with acute respiratory failure[J]. J Am Osteopath Assoc, 2007, 107(4):148-156.
13.	苏阳楚. BiPAP呼吸机治疗COPD并Ⅱ型呼吸衰竭48例疗效观察[J]. 临床和实验医学杂志, 2010, 9(22):1697-1698.
14.	Lellouche F, Brochard L. Advanced closed loops during mechanical ventilation (PAV, NAVA, ASV, SmartCare)[J]. Best Pract Res Clin Anaesthesiol, 2009, 23(1):81-93.
15.	刘新茹, 安立红, 贾红光, 等. COPD合并Ⅱ型呼衰应用无创通气患者依从性的原因及对策[J]. 临床肺科杂志, 2012, 17(7):1319-1320.
16.	王化强. BiPAP无创通气治疗急性左心功能衰竭对心功能和血浆内皮素、一氧化氮和脑钠肽浓度的影响[J]. 临床医学, 2011, 31(7):16-18.

1. 张婷. 无创正压通气在急性呼吸衰竭中的应用[J]. 医学综述, 2010, 16(14):2180-2182.
2. Agarwal R, Gupta R, Aggarwal AN, et al. Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs other causes:effectiveness and predictors of failure in a respiratory ICU in North India[J]. Int J Chron Obstruct Pulmon Dis, 2008, 3(4):737-743.
3. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2007年修订版)[J]. 中华内科杂志, 2007, 30(3):254-261.
4. Lim W, Bardwell WA, Lorsdo JS, et al. Neuropsychological effect of week continuous positive airway pressure treatment and supplemental oxygen in patients with obstructive sleep apnea:a randomized placebo-controlled study[J]. J Clin Sleep Med, 2007, 3(4):380-386.
5. 王丽霞, 赵静, 古力·喀德尔, 等. BiPAP联合纳洛酮治疗COPD急性加重期合并Ⅱ型呼吸衰竭的疗效观察[J]. 临床和实验医学杂志, 2011, 10(20):1611-1612.
6. Rothberg MB, Pekow PS, Lahti M, et al. Comparative effectiveness of macrolides and quinolones for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD)[J]. J Hosp Med, 2010, 5(5):261-267.
7. 虞松平, 梁永杰. 慢性阻塞性肺疾病合并心力衰竭的诊治进展[J]. 内科理论与实践, 2012, 7(3):237-240.
8. 马继扬, 高健, 梁民勇. BiPAP呼吸机治疗AECOPD合并Ⅱ型呼吸衰竭的疗效观察[J]. 临床和实验医学杂志, 2011, 10(11):819-821.
9. Williams AM, Abramo TJ, Shah MV, et al. Safety and clinical findings of BiPAP utilization in children 20 kg or less for asthma exacerbations[J]. Intensive Care Med, 2011, 37(8):1338-1343.
10. 李艳肖, 史金英, 袁德琴, 等. 无创正压通气治疗慢性阻塞性肺疾病急性加重期并重度二氧化碳潴留效果观察[J]. 临床误诊误治, 2013, 26(3):75-77.
11. Bassanezi BS, Oliveira-Filho AG, Miranda ML, et al. Use of BiPAP for safe anesthesia in a child with a large anterior mediastinal mass[J]. Paediatr Anaesth, 2011, 21(9):985-987.
12. Roy B, Cordova FC, Travaline JM, et al. Full face mask for noninvasive positive-pressure ventilation in patients with acute respiratory failure[J]. J Am Osteopath Assoc, 2007, 107(4):148-156.
13. 苏阳楚. BiPAP呼吸机治疗COPD并Ⅱ型呼吸衰竭48例疗效观察[J]. 临床和实验医学杂志, 2010, 9(22):1697-1698.
14. Lellouche F, Brochard L. Advanced closed loops during mechanical ventilation (PAV, NAVA, ASV, SmartCare)[J]. Best Pract Res Clin Anaesthesiol, 2009, 23(1):81-93.
15. 刘新茹, 安立红, 贾红光, 等. COPD合并Ⅱ型呼衰应用无创通气患者依从性的原因及对策[J]. 临床肺科杂志, 2012, 17(7):1319-1320.
16. 王化强. BiPAP无创通气治疗急性左心功能衰竭对心功能和血浆内皮素、一氧化氮和脑钠肽浓度的影响[J]. 临床医学, 2011, 31(7):16-18.

West China Medical Journal

Clinical Analysis on Noninvasive Ventilator in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Respiratory Failure

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