Abstract

Objective To observe the clinical effect of the acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients complicated with respiratory failure after different Sequential off-line (noninvasive positive pressure ventilation and noninvasive positive pressure ventilation combined with high-flow oxygen group). Method 48 patients over 60 years old with AECOPD treated by invasive mechanical ventilation. Patients were divided into two groups at random: 25 cases of group A (Non-invasive positive pressure ventilation sequential group) and 23 cases of group B (Non-invasive positive pressure ventilation combined with high-flow oxygen sequential group). Two groups received conventional treatment. According to daily SBT results and clinic experience, treatment team evaluated weaning. Group A treated by noninvasive positive pressure ventilation sequential therapy after weaning, Group B treated by noninvasive positive pressure ventilation combined with high flow oxygen sequencing. General information, clinical manifestation (age, sex, APACHE Ⅱ score, underlying diseases, SOFA score), vital signs and blood gas index (heart rate, breath, systolic pressure, oxygen partial pressure, partial pressure of carbon dioxide) after extubation (4 h, 8 h, 12 h, 24 h and 48 h), prognostic index (invasive positive pressure ventilation time), reintubation rate within and after 48 hours, duration of ICU stay, 28-day and 90-day mortality) were observed and recorded. Results There was no significant statistical difference in demography, clinical data, the duration of Invasive mechanical ventilation, reintubation rate within and after 48 hours, 28-day and 90-day mortality between two groups (P>0.05). Group B had a shorter duration of ICU stay than group A (P<0.05), showing a statistical difference. Conclusion Noninvasive positive pressure ventilation combined with high-flow oxygen sequencing shortened the duration of ICU stay. Key words: AECOPD; reintubation rate; Sequential therapy; High flow oxygen

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