Objective To analyze the effect of different nebulization methods in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) requiring non-invasive ventilators (NIV). Methods One hundred and two patients with AECOPD were selected according to the standard, and randomly divided into a control group, a trial group I, and a trial group II according to the random number table. The patients in the control group received NIV intermittent oxygen-driven nebulization; the patients in the trial group I received NIV simultaneous oxygen-driven nebulization; and the patients in the trial group II received NIV simultaneous air-driven nebulization. The dynamic fluctuations of transcutaneous partial pressure of carbon dioxide (PtCO₂), arterial blood gas indexes (PaCO₂, PaO₂, pH), vital signs and pulse oxygen saturation (SpO₂) fluctuations were compared. Results PtCO₂ at 15min of nebulization in the trial group II were lower than the other groups (P<0.05). PtCO₂ at 15min of nebulization was higher than the other time points in the control group (P<0.05); there was no statistical difference of PtCO₂ at different time points in the trial group I (P>0.05); PtCO₂ gradually decreased with time in the trial group II (P<0.05). The difference before and after nebulization of PtCO₂ (dPtCO₂) was larger in trial group II than the other groups (P<0.05). PtCO₂ at 0min and 5min after the end of nebulization in trial group II were lower than the other groups (P<0.05); there were no statistical differences of PtCO₂ at 10min and 15min after the end of nebulization among three groups (P>0.05). There were statistical differences of the PtCO₂ at each time point in the control group except for the PtCO₂ at 10 min and 15min after the end of nebulization, all of which decreased with time; PtCO₂ at each time points of nebulization decreased with time in the trial group I (P<0.05). PtCO₂ only at 5min after the end of nebulization was lower than that at 0min after the end of nebulization in trial group II (P< 0.05), there were no statistical differences in other times (P>0.05). PaCO₂, pH at the 4^th day of treatment was lower than the pre-treatment in the control group (P<0.01); there were statistical differences of PaCO₂ between the pre-treatment and the rest time points in the trial group I and group II (P<0.05). The number of abnormal fluctuations in vital signs and SpO₂ during nebulization in three groups was not statistically different (P>0.05). Conclusions Three groups can achieve good therapeutic effects. NIV intermittent oxygen-driven nebulization can make PtCO₂ rise during nebulization; NIV simultaneous oxygen-driven nebulization can make PtCO₂ remain stable during nebulization; NIV simultaneous air-driven nebulization can make PtCO₂ fall during nebulization.

Citation： YANG Yan, YAO Li, WAN Wenxia, JIA Xiaoying, LING Nan. Effect of different nebulization methods in acute exacerbations of chronic obstructive pulmonary disease requiring non-invasive ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(9): 615-623. doi: 10.7507/1671-6205.202307050 Copy