Application of Non-invasive Positive Pressure Ventilation Combined with PetCO₂ Monitoring for Patients with Chronic Obstructive Pulmonary Disease Combined with Severe Respiratory Failure.

Abstract

To investigate the role of PetCO₂ monitoring in non-invasive positive pressure ventilation (NPPV) treatment for chronic obstructive pulmonary disease (COPD) patients combined with severe respiratory failure. A clinical retrospective study. The ICU Emergency Department, Wuxi Second People's Hospital, Wuxi, China, from February 2015 to February 2016. A total of 60 COPD patients with respiratory failure were selected. All patients received non-invasive positive pressure ventilation and conventional treatment. PetCO₂ values were recorded two hours before and after NPPV treatment. At the same time, blood was collected for arterial blood gas analysis. Changes in PetCO₂, PaCO₂ and the difference between PaCO₂ and PetCO₂ (Pa-etCO₂) were also monitored to determine the correlation between PetCO₂ and PaCO₂. After two hours of initial NPPV treatment, among the 60 patients, the PaCO₂ and Pa-etCO₂ of 40 patients were significantly decreased (66.7%), the PaCO₂ and Pa-etCO₂ of 20 patients were not significantly decreased (33.3%). The correlation analysis revealed that PaCO₂ and PetCO₂ were negatively correlated (correlation coefficient r = -0.537, p=0.001, p<0.001). Furthermore, there were no significant correlations between PaCO₂ and PetCO₂ in the ineffective group (correlation coefficient r = -0.253, p=0.116, p>0.05). PaCO₂ monitoring could not be replaced by PetCO₂ monitoring for patients with COPD combined with severe respiratory failure. Nevertheless, dynamic monitoring can instantly feedback the respiration state, which can guide the respiration, and improve the success rate of NPPV treatment and prognosis.