Clinical efficacies of bilevel positive airway pressure ventilator treatment in uremic patients with acute heart failure

Abstract

To explore the clinical efficacies of bilevel positive airway pressure (BiPAP) ventilation in uremic patients with acute heart failure. Fifty uremic patients with acute heart failure on dialysis were recruited from February 2008 to October 2012 at our center. All of them received angiectasis, heart strengthening and continuous renal replacement therapy (CRRT), but their clinical symptoms had no relief 30 min later. Non-invasive ventilation was administered immediately. And the parametric changes of systolic pressure (SBP), diastolic pressure (DBP), heart rate (HR), breathing rate (R), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2) were observed at 30 min after conventional therapy and 1, 2 h later after non-invasive ventilation. And the levels of blood brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and clinical manifestations were observed at 2 h after non-invasive ventilation. Their clinical symptoms improved after BiPAP ventilation. And SBP, DBP, P, R and BNP showed a declining tendency, but PaO2 and LVEF showed a rising trend. Compared to conventional therapy, SBP ((160 ± 17), (147 ± 18) vs (172 ± 20) mmHg) (1 mmHg = 0.133 kPa), DBP ((90 ± 9), (85 ± 10) vs (98 ± 10) mmHg), HR ((95 ± 8), (88 ± 9) vs (102 ± 12) times/min), R ((20 ± 3), (17 ± 4) vs (26 ± 3) times/min) declined while PaO2 ((87 ± 9), (94 ± 12) vs (81 ± 9) mmHg) increased significantly, 1, 2 h later after noninvasive ventilator treatment (all P < 0.05); the blood level of BNP decreased ((1084 ± 398) vs (2686 ± 576) µg/L), LVEF elevated (52% ± 7% vs 39% ± 9%) significantly, 2 h later after noninvasive ventilator treatment (both P < 0.01). As a safe and effective intervention, early use of BiPAP ventilator-assisted breathing in uremic patients with acute heart failure effectively ameliorates their clinical manifestations and improve heart function.