Application of invasive and non-invasive sequential ventilation in severe chronic obstructive pulmonary disease

Abstract

Twenty four patients of chronic obstructive pulmonary disease complicated with severe respiratory failure were divided into two groups randomly: sequential ventilation group and control ventilation group (n = 12 in each group). Patients in sequential group received invasive ventilation at beginning, once the pulmonary infection control window (PICW) reached the trachea cannula was extubated immediately replaced by Bi-level positive airway pressure( BiPAP) noninvasive ventilation with oral-nasal mask; while in control ventilation group the invasive ventilation was continued using pressure support ventilation (PSV) until stopping mechanical ventilation. The total ventilation time, the invasive ventilated time,the length of stay in hospital,monitoring time and the incidence rate of ventilation associated pneumonia (VAP) were evaluated in two groups. The total ventilation time [(7. 8 ±2. 5 ) d, (12 ±2. 2) d], the invasive ventilated time [(4. 9 ±2. 2)d, and (12 ± 2. 2) d] the length of hospital stay [(8. 5 ± 2. 5 ) d, (13 ± 2. 6) d] in the sequential ventilation group were significantly shorter than those in the control ventilation group (P ＜ 0.05); the incidence rate of VAP was lower than that in the control group. The results indicates that sequential ventilation with the guidance of PICW can shorten the total ventilation time, the critical monitoring time and the length of hospital stay, it can also reduce the incidence of VAP and improve the prognosis of patients. Key words: Respiratory, artificial; Pulmonary disease, chronic obstructive