Analysis of the efficacy of invasive positive pressure ventilation and noninvasive positive pressure ventilation in AECOPD patients

Abstract

Objective To compare the different efficacy between invasive positive pressure ventilation and noninvasive positive pressure ventilation of acute exacerbation chronic obstructive pulmonary 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.Results After 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.Conclusion IPPV 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. Key words: Chronic obstructive pulmonary disease; Invasive positive pressure ventilation; Noninvasive positive pressure ventilation